Antiagregation and anticoagulation, relationship with upper gastrointestinal bleeding

Abstract

Introduction: the high prevalence of cardiovascular diseases in the modern society brings a high prescription of platelet antiaggre-gation 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 melli-tus 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. © 2011 ARÁN EDICIONES, S. L.