Mortality in patients who discontinue low-dose acetylsalicylic acid therapy after upper gastrointestinal bleeding

2016 ◽  
Vol 26 (2) ◽  
pp. 215-222 ◽  
Author(s):  
Antonio González-Pérez ◽  
María Eugenia Sáez ◽  
Saga Johansson ◽  
Péter Nagy ◽  
Luis A. García Rodríguez
Keyword(s):  
Gastrointestinal Bleeding ◽  
Acetylsalicylic Acid ◽  
Low Dose ◽  
Upper Gastrointestinal Bleeding ◽  
Acid Therapy ◽  
Upper Gastrointestinal

Mo1159 Mortality in Patients Who Discontinue Low-Dose Acetylsalicylic Acid Therapy After an Upper Gastrointestinal Bleeding Event

2015 ◽  
Vol 148 (4) ◽  
pp. S-624
Author(s):  
Antonio Gonzalez-Perez ◽  
Maria E. Saez ◽  
Saga Johansson ◽  
Péter Nagy ◽  
Luis A. Garcia Rodriguez
Keyword(s):  
Gastrointestinal Bleeding ◽  
Acetylsalicylic Acid ◽  
Low Dose ◽  
Upper Gastrointestinal Bleeding ◽  
Bleeding Event ◽  
Acid Therapy ◽  
Upper Gastrointestinal

scholarly journals Risk of Upper Gastrointestinal Bleeding With Low-Dose Acetylsalicylic Acid Alone and in Combination With Clopidogrel and Other Medications

Circulation ◽  
2011 ◽  
Vol 123 (10) ◽  
pp. 1108-1115 ◽  
Author(s):  
Luis A. García Rodríguez ◽  
Kueiyu Joshua Lin ◽  
Sonia Hernández-Díaz ◽  
Saga Johansson
Keyword(s):  
Gastrointestinal Bleeding ◽  
Acetylsalicylic Acid ◽  
Low Dose ◽  
Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal

scholarly journals Low-Dose Acetylsalicylic Acid Use and the Risk of Upper Gastrointestinal Bleeding: A Meta-Analysis of Randomized Clinical Trials and Observational Studies

2013 ◽  
Vol 27 (3) ◽  
pp. 159-167 ◽  
Author(s):  
Vera E Valkhoff ◽  
Miriam CJM Sturkenboom ◽  
Catherine Hill ◽  
Sander Veldhuyzen van Zanten ◽  
Ernst J Kuipers
Keyword(s):  
Gastrointestinal Bleeding ◽  
Acetylsalicylic Acid ◽  
Observational Studies ◽  
Low Dose ◽  
Randomized Clinical Trials ◽  
Upper Gastrointestinal Bleeding ◽  
Meta Analysis ◽  
Case Control Studies ◽  
Increased Risk ◽  
Upper Gastrointestinal

BACKGROUND: Low-dose acetylsalicylic acid (LDA, 75 mg/day to 325 mg/day) is recommended for primary and secondary prevention of cardiovascular events, but has been linked to an increased risk of upper gastrointestinal bleeding (UGIB).OBJECTIVE: To analyze the magnitude of effect of LDA use on UGIB risk.METHODS: The PubMed and Embase databases were searched for randomized controlled trials (RCTs) reporting UGIB rates in individuals receiving LDA, and observational studies of LDA use in patients with UGIB. Studies were pooled for analysis of UGIB rates.RESULTS: Eighteen studies were included. Seven RCTs reported UGIB rates in individuals randomly assigned to receive LDA (n=22,901) or placebo (n=22,923). Ten case-control studies analyzed LDA use in patients with UGIB (n=10,816) and controls without UGIB (n=30,519); one cohort study reported 207 UGIB cases treated with LDA only. All studies found LDA use to be associated with an increased risk of UGIB. The mean number of extra UGIB cases associated with LDA use in the RCTs was 1.2 per 1000 patients per year (95% CI 0.7 to 1.8). The number needed to harm was 816 (95% CI 560 to 1500) for RCTs and 819 (95% CI 617 to 1119) for observational studies. Meta-analysis of RCT data showed that LDA use was associated with a 50% increase in UGIB risk (OR 1.5 [95% CI 1.2 to 1.8]). UGIB risk was most pronounced in observational studies (OR 3.1 [95% CI 2.5 to 3.7]).CONCLUSIONS: LDA use was associated with an increased risk of UGIB.

Cardiovascular and upper gastrointestinal bleeding consequences of low-dose acetylsalicylic acid discontinuation

2013 ◽  
Vol 110 (12) ◽  
pp. 1298-1304 ◽  
Author(s):  
Lucía Soriano ◽  
Héctor Bueno ◽  
Angel Lanas ◽  
Luis Rodríguez
Keyword(s):  
Gastrointestinal Bleeding ◽  
Acetylsalicylic Acid ◽  
Low Dose ◽  
Upper Gastrointestinal Bleeding ◽  
Cardiovascular Prevention ◽  
Health Improvement ◽  
Coronary Death ◽  
Upper Gastrointestinal ◽  
Secondary Cardiovascular Prevention

SummaryIt was the aim of this study to investigate whether low-dose acetylsalicylic acid (ASA) therapy for secondary cardiovascular prevention should continue, despite the risk of gastrointestinal bleeding. We aimed to make a clinically meaningful benefit–risk assessment regarding the cardiovascular and gastrointestinal consequences of ASA discontinuation. This case–control study used The Health Improvement Network UK primary care database to identify patients aged 50–84 years during 2000–2007 with a first ASA prescription for secondary cardiovascular prevention (N = 39,513). New cases of non-fatal myocardial infarction (MI)/coronary death (n = 1,222), ischaemic stroke (IS)/transient ischaemic attack (TIA) (n = 673) and upper gastrointestinal bleeding (UGIB) (n = 169) were identified after a mean follow-up of 3.2, 3.4 and 4.0 years, respectively. ASA discontinuers before the index date were identified. Attributable risks associated with ASA discontinuation were calculated and National Institute for Health and Clinical Excellence annual economic data were used to estimate healthcare costs. The cumulative incidences of non-fatal MI/coronary death, IS/TIA and UGIB among ASA discontinuers within the first year of follow-up were 17, 11 and 1.6 per 1,000 persons, respectively. This corresponds to eight extra cardiovascular events, and a reduction of 0.4 UGIB events per year compared with current ASA users. Extrapolating to the UK population aged over 50 years, avoiding discontinuation of ASA could prevent 12,786 coronary and 7,672 cerebrovascular events/year, at the expense of 1023 extra UGIB events, saving approximately £100 million/year. In conclusion, preventing patients with cardiovascular disease from discontinuing ASA could result in substantial clinical and economic gains.

661 Low-Dose Acetylsalicylic Acid use and the Risk of Upper Gastrointestinal Bleeding: A Systematic Literature Analysis

2010 ◽  
Vol 138 (5) ◽  
pp. S-89
Author(s):  
Ernst J. Kuipers ◽  
Catherine Hill ◽  
Sander Veldhuyzen van Zanten
Keyword(s):  
Gastrointestinal Bleeding ◽  
Acetylsalicylic Acid ◽  
Low Dose ◽  
Upper Gastrointestinal Bleeding ◽  
Literature Analysis ◽  
Upper Gastrointestinal

Patterns in the Use of Low-Dose Acetylsalicylic Acid and Other Therapies Following Upper Gastrointestinal Bleeding

2014 ◽  
Vol 14 (6) ◽  
pp. 443-450 ◽  
Author(s):  
María E. Sáez ◽  
Antonio González-Pérez ◽  
Saga Johansson ◽  
Péter Nagy ◽  
Luis A. García Rodríguez
Keyword(s):  
Gastrointestinal Bleeding ◽  
Acetylsalicylic Acid ◽  
Low Dose ◽  
Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal
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