title: [Risk factors of upper gastrointestinal complications in outpatients on antiplatelet therapy: description and management].
abstract: OBJECTIVE
  Patients on antiplatelet therapy have a gastrointestinal bleeding risk. It is increased by risk factors. The frequency of those risk factors, the prevalence of upper digestive symptoms and their management in patients on antiplatelet agents is unknown.
  
  
  METHODS
  We performed an observational multi-centred prospective survey among 560 French cardiologists with private practice. Each cardiologist completed a questionnaire for the first four patients treated with antiplatelet agents in primary or secondary prevention.
  
  
  RESULTS
  Among the 2182 patients included, (age = 67 ± 11 years; 74% male), 83% had at least one gastrointestinal bleeding risk factor and 38.9% had a history of upper digestive tract symptom. A history of gastrointestinal bleeding was reported in 3.4% and a history of documented gastro-duodenal ulcer in 5.5%. A proton pump inhibitor was already prescribed in 39% of the patients. At the time of the consultation, upper digestive symptoms were described in 21% of the patients. In those patients with symptoms, 85% had no modification in antiplatelet therapy and 62.7% were prescribed gastro-protective drugs (proton pump inhibitors: 51.8%, H(2)-blockers 3.6% other anti-acid medication: 7.3%).
  
  
  CONCLUSIONS
  Among patients on antiplatelet agents, the prevalence of upper digestive symptoms and risk factors for gastrointestinal bleeding is high. Preventative management needs to be clarified in this population.
authors.affiliation: Inserm U698, recherche clinique en athérothrombose, service de cardiologie, centre hospitalier Bichat Claude-Bernard, université Paris-Diderot, 46, rue Henri-Huchard, 75018 Paris, France. gregory.ducrocq@bch.aphp.fr
authors.forename: G
authors.initials: G
authors.lastname: Ducrocq
authors.forename: M-A
authors.initials: MA
authors.lastname: Bigard
authors.forename: S
authors.initials: S
authors.lastname: Marouene
authors.forename: P-H
authors.initials: PH
authors.lastname: Delaage
authors.forename: C
authors.initials: C
authors.lastname: Fabry
authors.forename: P
authors.initials: P
authors.lastname: Barthelemy
authors.forename: P-G
authors.initials: PG
authors.lastname: Steg
mesh_terms: D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D002309:Cardiology; D002318:Cardiovascular Diseases / Q000517:prevention & control; D004359:Drug Therapy, Combination; D005260:Female; D005602:France / Q000453:epidemiology; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000517:prevention & control; D019538:Health Care Surveys; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data*; D010438:Peptic Ulcer Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control*; D010820:Physicians / Q000706:statistics & numerical data*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D015995:Prevalence; D011331:Private Practice; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D013276:Stomach Ulcer / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D041742:Upper Gastrointestinal Tract / Q000187:drug effects
chemical_list: D000897:Anti-Ulcer Agents; D005765:Gastrointestinal Agents; D006635:Histamine H2 Antagonists; D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors