Single antiplatelet therapy for patients with previous gastrointestinal bleeds.

Single antiplatelet therapy for patients with previous gastrointestinal bleeds. Research Abstract Details 

Research Abstract Table of Contents

Jump to the:

Single antiplatelet therapy for patients with previous gastrointestinal bleeds. Abstract Text:

OBJECTIVE: To determine whether aspirin plus a proton pump inhibitor (PPI) is preferable, from a gastrointestinal bleed (GIB) risk perspective, to clopidogrel in patients who have experienced a GIB while on aspirin and who require single antiplatelet therapy for secondary prevention of cardiovascular disease. DATA SOURCES: A literature search was conducted using EMBASE (1980-January 2008), PubMed (1966-January 2008), Google, and a manual search of the reference lists using the search terms gastrointestinal bleed, gastrointestinal hemorrhage, peptic ulcer hemorrhage, ASA, aspirin, Plavix, clopidogrel, and PPI. The search, limited to human and English studies, yielded 110 returns. STUDY SELECTION AND DATA EXTRACTION: Randomized trials that compared aspirin with clopidogrel, involved patients who had previously experienced a GIB, and provided detailed information on the type and dose of drugs used were included. Studies were required to provide information on the recurrence of GIB. DATA SYNTHESIS: Two randomized trials were reviewed to assess the safety of secondary prevention of cardiovascular disease with respect to previous GIB. These noninferiority trials compared aspirin plus a PPI with clopidogrel over 12 months following confirmed healing of an aspirin-induced ulcer. In both trials, the majority of the GIB recurrences were in the clopidogrel group (8.6% vs 0.7%; difference 7.9%; 95% CI 3.4 to 12.4; p = 0.001 and 13.6% vs 0%; difference 13.6%; 95% CI 6.3 to 20.9; p = 0.0019) and the difference in recurrence rates exceeded the a priori selected upper boundary. CONCLUSIONS: Findings reported in the limited literature available support that clopidogrel is not equivalent to the combination of aspirin plus a PPI in the patient population studied. Aspirin plus a PPI would be considered clinically superior and should be used in medically managed patients who require single antiplatelet therapy but have had a prior GIB while on aspirin. Further research regarding dual antiplatelet therapy and a PPI is required.

Single antiplatelet therapy for patients with previous gastrointestinal bleeds. Publishing Authors By Initials

For similar abstracts research abstracts see: abstracts research

PUBMED ID PMID:

MEDLINE DATE:

Single antiplatelet therapy for patients with previous gastrointestinal bleeds. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: The Annals of pharmacotherapy

VOLUME: 42

Page Numbers: 836-40

Journal Abbreviation:

ISSN: 1542-6270

DAY: 15

MONTH: 04

YEAR: 2008

Single antiplatelet therapy for patients with previous gastrointestinal bleeds. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 9203131

Single antiplatelet therapy for patients with previous gastrointestinal bleeds. Keywords Mesh Terms:

KEYWORDS:

MESH TERMS:

Chemical & Substance for Abstract: Single antiplatelet therapy for patients with previous gastrointestinal bleeds. Information

Substance Name:

Registry Number:

Grant and Affiliation Information for Single antiplatelet therapy for patients with previous gastrointestinal bleeds.

AFFILIATION: Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.

Country: United States

AGENCY:

GRANT:

ACRONYM:

MEDLINETA: Ann Pharmacother

REFSOURCE:

DATABASENAME:

ACCESSION NUMBER:

Number Hits: 0

Single antiplatelet therapy for patients with previous gastrointestinal bleeds Related Publications

• Analysis of the monoethylenic fatty acids of rapeseed oil by open tubular gas chromatography.
• Effect of bromocriptine in patients with apomorphine-responsive erectile impotence: an open study.
• Removal of organochlorine pesticides and polychlorinated biphenyls from marine oils during refining and hydrogenation for edible use.
• Single antiplatelet therapy for patients with previous gastrointestinal bleeds.
• The chain-length overlap problem in gas-liquid chromatography with polyester liquid phases.
• Trace metal content of a herring oil at various stages of pilot-plant refining and partial hydrogenation.