Management and outcome of peptic ulcers or erosions in patients receiving a combination of aspirin plus clopidogrel.
BACKGROUND
This multicenter retrospective study investigated the management and outcome of patients with peptic ulcer/erosion-related aspirin and clopidogrel (A + C) cotherapy.


METHODS
From January 2002 to September 2006, patients with endoscopically proven peptic ulcers/erosions after receiving A + C cotherapy were analyzed.


RESULTS
This group consisted of 106 patients (age, 69.3 +/- 11.7 years). Ulcers/erosions developed in 27 patients during hospitalization for cardiac events and in 79 patients after hospital discharge. Of 27 patients hospitalized for acute cardiac events, gastrointestinal (GI) bleeding and dyspepsia occurred in 24 and three, respectively. The most common lesion was gastric ulcer. Of 79 discharged patients, GI bleeding and dyspepsia occurred in 64 and 15, respectively. The most common bleeding and dyspeptic lesions were gastric ulcer and gastritis, respectively. Overall, 17 patients underwent endoscopic hemostasis all successfully. A + C cotherapy was continued in 57 patients for a median (interquartile range) of 3.0 (6.2) months. Most were coprescribed a proton pump inhibitor (PPI) (53, 93%). No recurrent GI bleeding was observed.


CONCLUSIONS
After A + C cotherapy, gastric ulcer or gastritis were the most common endoscopic lesions. The combination of a PPI and endoscopic treatment for ulcer bleeding was highly successful. After patient stabilization, continuation of A + C cotherapy with a PPI appears to be safe.
Ng
Fook Hong
FH
Department of Medicine & Surgery, Ruttonjee Hospital, 266 Queen's Road East, Wai Chai, Hong Kong, China.
Chan
Pierre
P
Kwanching
Chi Pong
CP
Loo
Ching Kong
CK
Cheung
Ting Kin
TK
Wong
Siu Yin
SY
Kng
Carolyn
C
Ng
Ka Man
KM
Lai
Sik To
ST
Wong
Benjamin Chun Yu
BC
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D000077144:Clopidogrel; D003327:Coronary Disease / Q000628:therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy; D016558:Hemostasis, Endoscopic; D006760:Hospitalization; D006801:Humans; D008297:Male; D010437:Peptic Ulcer / Q000139:chemically induced* / Q000150:complications / Q000628:therapy; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015607:Stents; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin