title: Management and outcome of peptic ulcers or erosions in patients receiving a combination of aspirin plus clopidogrel.
abstract: 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.
authors.affiliation: Department of Medicine & Surgery, Ruttonjee Hospital, 266 Queen's Road East, Wai Chai, Hong Kong, China.
authors.forename: Fook Hong
authors.initials: FH
authors.lastname: Ng
authors.forename: Pierre
authors.initials: P
authors.lastname: Chan
authors.forename: Chi Pong
authors.initials: CP
authors.lastname: Kwanching
authors.forename: Ching Kong
authors.initials: CK
authors.lastname: Loo
authors.forename: Ting Kin
authors.initials: TK
authors.lastname: Cheung
authors.forename: Siu Yin
authors.initials: SY
authors.lastname: Wong
authors.forename: Carolyn
authors.initials: C
authors.lastname: Kng
authors.forename: Ka Man
authors.initials: KM
authors.lastname: Ng
authors.forename: Sik To
authors.initials: ST
authors.lastname: Lai
authors.forename: Benjamin Chun Yu
authors.initials: BC
authors.lastname: Wong
mesh_terms: 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*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin