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Upper gastrointestinal lesions in patients receiving clopidogrel anti-platelet therapy.
MedLine Citation:
PMID:  23265750     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND/PURPOSE: Clopidogrel is associated with a high incidence of upper gastrointestinal bleeding in high-risk patients. However, the characteristic upper gastrointestinal lesions in symptomatic clopidogrel users remain unclear. The aims of this study were to investigate the characteristics of endoscopic findings in clopidogrel users undergoing endoscopy for upper gastrointestinal symptoms and to compare the clinical characteristics and upper gastrointestinal lesions between symptomatic clopidogrel and aspirin users.
METHODS: This observational study included 215 consecutive patients receiving clopidogrel (n=106) or low-dose aspirin (n=109) therapy who underwent endoscopy for dyspeptic symptoms. The upper gastrointestinal lesions were carefully assessed, and a complete medical history was obtained by a standard questionnaire.
RESULTS: The frequencies of hemorrhagic spots, erosions and peptic ulcers in the symptomatic clopidogrel users were 25%, 39% and 39%, respectively. Among the peptic ulcer patients on clopidogrel therapy, the distributions of ulcers were 78%, 5% and 17% in the stomach, duodenum and both, respectively. Compared with the aspirin group, the clopidogrel group was older and had higher frequencies of past ulcer history and past gastrointestinal bleeding history in their clinical characteristics. By contrast, the clopidogrel users had a lower prevalence of active Helicobacter pylori infection than aspirin users (17% vs. 35%, respectively, p=0.007). Regarding to the endoscopic findings, the clopidogrel users had higher frequencies of hemorrhagic spots (25% vs. 10%) and peptic ulcer (39% vs. 24%) than aspirin users (p=0.004 and 0.027, respectively).
CONCLUSION: Most peptic ulcers in clopidogrel users are located in the stomach. The frequencies of hemorrhagic spots and peptic ulcers in symptomatic clopidogrel users are higher than those in symptomatic aspirin users.
Authors:
Tzung-Jiun Tsai; Kwok-Hung Lai; Ping-I Hsu; Chiun-Ku Lin; Hoi-Hung Chan; Hsien-Chung Yu; Huay-Min Wang; Kung-Hung Lin; Kai-Ming Wang; Shiuh-Nan Chang; Chun-Peng Liu; Shin-Hung Hsiao; Hung-Ru Huang; Ching-Huang Lin; Feng-Woei Tsay
Publication Detail:
Type:  Journal Article     Date:  2012-05-02
Journal Detail:
Title:  Journal of the Formosan Medical Association = Taiwan yi zhi     Volume:  111     ISSN:  0929-6646     ISO Abbreviation:  J. Formos. Med. Assoc.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9214933     Medline TA:  J Formos Med Assoc     Country:  China (Republic : 1949- )    
Other Details:
Languages:  eng     Pagination:  705-10     Citation Subset:  IM    
Copyright Information:
Copyright © 2012. Published by Elsevier B.V.
Affiliation:
Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology, Department of Internal Medicine, Yongkong Veterans Hospital, Tainan, Taiwan.
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