Year 2011 / Volume 103 / Number 7
Original
Antiagregation and anticoagulation, relationship with upper gastrointestinal bleeding

pp. 360-365

Philip Wikman Jorgensen, Eva López Calleja, Pablo Safont Gasó, Mariano Matarranz del Amo, Raquel Andrés Navarro y Jaime Merino Sánchez

Abstract
Introduction: the high prevalence of cardiovascular diseases in the modern society brings a high prescription of platelet antiaggregation
and anticoagulant medications. These treatments have been related to an increased incidence of upper gastrointestinal bleedings (UGB). Our aim was to estimate the fraction of UGB s presented
to our hospital that was related to this kind of treatments and describe their clinical features in our environment.

Material and methods: a retrospective search was performed in the archives of our hospital of all the patients with diagnosis of UGB admitted during the period 2004-2007 both years inclusive.
Patients on antiplatelet and/or anticoagulant treatment were included.
We analyzed the information regarding the use of medication, the bleeding lesion, the severity of the bleeding, recurrences, mortality and their clinical features.

Results: we found 523 episodes of UGB. Of these 137 (26.1%) were patients receiving platelet antiaggregation or anticoagulant drugs. The patients were male 60.2%, and had a mean age of 75.6 (± 10.8) years. The 65.5% (74) had HBP, 43.4% (49) diabetes mellitus and 37.2% (42) dislypemia and 13.3% (22) dementia.
The drug most frequently implicated was ASA in 36.3% (41), followed by acenocumarol in 27.4% (31), clopidogrel 18.6% (21), double therapy (ASA + clopidogrel) in 6.2% (7), triple therapy (ASA + clopidogrel + acenocumarol) in 0.9% (1), triflusal 4.4% (5), low molecular weight heparin 5.3% (5), and ticlopidine in one patient
(0.9%). Only 36.3% (41) were on treatment with proton pump inhibitors.
There were 24 recurrences and 4 deaths.

Conclusions: the 26.1% of the UGB attended in our environment were of iatrogenic origin. We also found a low use of proton pump inhibitors.
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Philip Wikman Jorgensen, Eva López Calleja, Pablo Safont Gasó, Mariano Matarranz del Amo, Raquel Andrés Navarro y Jaime Merino Sánchez. Antiagregation and anticoagulation, relationship with upper gastrointestinal bleeding. 360-365


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