Effect of Low-dose, Enteric Coated Aspirin on Gastrointestinal Bleeding in Patients with Coronary Artery Disease.
OBJECTIVE
This study was performed to determine whether low-dose aspirin and/or clopidogrel can induce gastrointestinal bleeding and gastroduodenal mucosal injury.


METHODS
A total of 387 patients who underwent coronary angiography at Seoul National University Bundang Hospital were assigned to one of three antiplatelet treatment groups: (1) control, (2) 100-mg enteric coated aspirin, and (3) 100-mg enteric coated aspirin plus clopidogrel. The incidences of gastroduodenal mucosal injury and gastrointestinal bleeding were prospectively evaluated, and risk factors for gastrointestinal bleeding were analyzed.


RESULTS
for gastrointestinal bleeding were analyzed.


RESULTS
The rate of gastroduodenal mucosal injury was higher in the aspirin-plus-clopidogrel group than in the aspirin group (p=0.012), and higher in the aspirin group than in the control group (p=0.049). The rate of gastrointestinal bleeding was significantly higher in the aspirin-plus-clopidogrel group (9.4%) than in the control group (2.4%, p=0.048). The risk factors for gastrointestinal bleeding were older age (>/=60 years) and the presence of at least two comorbid disorders.


CONCLUSIONS
Low-dose enteric coated aspirin was found to be safe in patients with coronary artery disease, but the addition of clopidogrel increased the rate of gastrointestinal bleeding. Combined clopidogrel and aspirin should be used with caution in older patients having at least two comorbid conditions.
Choi
Chang Kyu
CK
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea.
Kim
Nayoung
N
Choi
Jin Woo
JW
Park
Young Soo
YS
Kim
Jin-Wook
JW
Jeong
Sook-Hyang
SH
Lee
Dong Ho
DH
Cho
Young-Seok
YS
Youn
Tae-Jin
TJ
Chung
Woo-Young
WY
Chae
In-Ho
IH
Choi
Dong-Ju
DJ