Premium
High incidence of clopidogrel‐associated gastrointestinal bleeding in patients with previous peptic ulcer disease
Author(s) -
Ng F. H.,
Wong S. Y.,
Chang C. M.,
Chen W. H.,
Kng C.,
Lanas A. I.,
Wong B. C. Y.
Publication year - 2003
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2003.01693.x
Subject(s) - medicine , clopidogrel , aspirin , gastrointestinal bleeding , odds ratio , gastroenterology , incidence (geometry) , perforation , upper gastrointestinal bleeding , melena , adverse effect , retrospective cohort study , surgery , endoscopy , physics , materials science , optics , punching , metallurgy
Summary Background: In average‐risk patients, the new anti‐platelet agent, clopidogrel, causes less upper gastrointestinal adverse events than aspirin. However, there are no safety data on the use of clopidogrel in high‐risk patients. Aim: To evaluate the safety of clopidogrel in patients with peptic ulcer disease in a retrospective cohort longitudinal study. Methods: During the period from January 2000 to May 2002, 70 patients who were prescribed clopidogrel (75 mg/day) for a previous history of non‐aspirin‐related peptic ulcer disease or a history of aspirin‐related gastrointestinal complications (dyspepsia or peptic ulcer) were recruited. The occurrence of ulcer complications (bleeding/perforation/obstruction) was the primary end‐point. Results: After a median follow‐up of 1 year, nine patients (12%) developed gastrointestinal bleeding and one had a perforated peptic ulcer. Clopidogrel‐associated gastrointestinal bleeding was significantly more common in patients with a history of gastrointestinal bleeding than in those without (22% vs. 0%; P = 0.007; odds ratio, 1.3; 95% confidence interval, 1.1–1.5). Conclusions: Clopidogrel is associated with a high incidence of upper gastrointestinal bleeding in high‐risk patients. A previous history of gastrointestinal bleeding appears to be a predictor of adverse gastrointestinal events.