title: Antiagregation and anticoagulation, relationship with upper gastrointestinal bleeding.
abstract: BACKGROUND
  the high prevalence of cardiovascular diseases in the modern society brings a high prescription of platelet antiaggregation and anticoagulant medications. These treatments have been related to an increased incidence of upper gastrointestinal bleedings (UGB). Our aim was to estimate the fraction of UGB´s presented to our hospital that was related to this kind of treatments and describe their clinical features in our environment.
  
  
  METHODS
  a retrospective search was performed in the archives of our hospital of all the patients with diagnosis of UGB admitted during the period 2004-2007 both years inclusive. Patients on antiplatelet and/or anticoagulant treatment were included. We analyzed the information regarding the use of medication, the bleeding lesion, the severity of the bleeding, recurrences, mortality and their clinical features.
  
  
  RESULTS
  we found 523 episodes of UGB. Of these 137 (26.1%) were patients receiving platelet antiaggregation or anticoagulant drugs. The patients were male 60.2%, and had a mean age of 75.6 (± 10.8) years. The 65.5% (74) had HBP, 43.4% (49) diabetes mellitus and 37.2% (42) dislypemia and 13.3% (22) dementia.The drug most frequently implicated was ASA in 36.3% (41), followed by acenocumarol in 27.4% (31), clopidogrel 18.6% (21), double therapy (ASA + clopidogrel) in 6.2% (7), triple therapy (ASA + clopidogrel + acenocumarol) in 0.9% (1), triflusal 4.4% (5), low molecular weight heparin 5.3% (5), and ticlopidine in one patient (0.9%). Only 36.3% (41) were on treatment with proton pump inhibitors. There were 24 recurrences and 4 deaths.
  
  
  CONCLUSIONS
  the 26.1% of the UGB attended in our environment were of iatrogenic origin. We also found a low use of proton pump inhibitors.
authors.affiliation: Department of Internal Medicine, Hospital de San Juan de Alicante, Spain. pwjpwj@hotmail.com
authors.forename: Philip Wikman
authors.initials: PW
authors.lastname: Jorgensen
authors.forename: Eva López
authors.initials: EL
authors.lastname: Calleja
authors.forename: Pablo Safont
authors.initials: PS
authors.lastname: Gasó
authors.forename: Mariano
authors.initials: M
authors.lastname: Matarranz del Amo
authors.forename: Raquel Andrés
authors.initials: RA
authors.lastname: Navarro
authors.forename: Jaime Merino
authors.initials: JM
authors.lastname: Sánchez
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D023381:Endpoint Determination; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors