Aspirin Has a Protective Effect Against Adverse Outcomes in Patients with Nonvariceal Upper Gastrointestinal Bleeding

Digestive Diseases and Sciences

Volumn 60, Issue 7, 2015, Pages 2077-2087

  Wehbeh, Antonios ^a   Tamim, Hani M ^a   Abu Daya, Hussein ^b   Abou Mrad, Rachel ^a   Badreddine, Rami J ^a   Eloubeidi, Mohamad A ^a   Rockey, Don C ^c   Barada, Kassem ^a  

^a AMERICAN UNIVERSITY OF BEIRUT   (Lebanon)

^b UNIVERSITY OF PITTSBURGH MEDICAL CENTER   (United States)

^c MEDICAL UNIVERSITY OF SOUTH CAROLINA   (United States)

Author keywords

Anticoagulant; Aspirin; Hemorrhage; Morbidity; Mortality; Outcome

Indexed keywords

ACETYLSALICYLIC ACID; ADRENALIN; CLOPIDOGREL; DIPYRIDAMOLE; HEPARIN; NONSTEROID ANTIINFLAMMATORY AGENT; PROTON PUMP INHIBITOR; TICLOPIDINE; WARFARIN; FIBRINOLYTIC AGENT;

ADULT; AGED; ALCOHOL CONSUMPTION; ARGON PLASMA COAGULATION; ARTICLE; ATRIAL FIBRILLATION; BLOOD TRANSFUSION; BLOOD VESSEL CLIP; CARDIOVASCULAR DISEASE; CAUSE OF DEATH; CEREBROVASCULAR DISEASE; COHORT ANALYSIS; CONTROLLED STUDY; CORONARY ARTERY DISEASE; DEEP VEIN THROMBOSIS; DIABETES MELLITUS; DIGESTIVE SYSTEM CANCER; DISEASE SEVERITY; DRUG EFFECT; DYSLIPIDEMIA; ENDOSCOPIC THERAPY; FAINTNESS; FEMALE; GASTROINTESTINAL HEMORRHAGE; HIATUS HERNIA; HUMAN; HYPERTENSION; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; MELENA; MORTALITY; MULTIPLE ORGAN FAILURE; NONVARICEAL UPPER GASTROINTESTINAL BLEEDING; OUTCOME ASSESSMENT; PEPTIC ULCER; PERIPHERAL VASCULAR DISEASE; PREVALENCE; PRIORITY JOURNAL; RETROSPECTIVE STUDY; SEPSIS; STOMACH PROTECTION; THROMBOEMBOLISM; UPPER GASTROINTESTINAL BLEEDING; AGING; CARDIOVASCULAR DISEASES; COMPLICATION; MIDDLE AGED; NEOPLASMS; PATHOLOGY; RENAL INSUFFICIENCY, CHRONIC; RISK; RISK FACTOR; UPPER GASTROINTESTINAL TRACT;

ADULT; AGED; AGING; ASPIRIN; CARDIOVASCULAR DISEASES; DIABETES MELLITUS; FEMALE; FIBRINOLYTIC AGENTS; GASTROINTESTINAL HEMORRHAGE; HUMANS; MALE; MIDDLE AGED; NEOPLASMS; ODDS RATIO; RENAL INSUFFICIENCY, CHRONIC; RETROSPECTIVE STUDIES; RISK FACTORS; UPPER GASTROINTESTINAL TRACT;

EID: 84930817897     PISSN: 01632116     EISSN: 15732568     Source Type: Journal    
DOI: 10.1007/s10620-015-3604-1     Document Type: Article

References (38)

1. British Society of Gastroenterology Endoscopy Committee. Non-variceal upper gastrointestinal haemorrhage: guidelines. Gut. 2002;51:iv1–iv6.
2. Wolf AT, Wasan SK, Saltzman JR. Impact of anticoagulation on rebleeding following endoscopic therapy for nonvariceal upper gastrointestinal hemorrhage. Am J Gastroenterol. 2007;102:290–296.
3. Hearnshaw SA, Logan RF, Lowe D, Travis SP, Murphy MF, Palmer KR. Acute upper gastrointestinal bleeding in the UK: patient characteristics, diagnoses and outcomes in the 2007 UK audit. Gut. 2011;60:1327–1335.
4. van Leerdam ME, Vreeburg EM, Rauws EA, et al. Acute upper GI bleeding: Did anything change? Time trend analysis of incidence and outcome of acute upper GI bleeding between 1993/1994 and 2000. Am J Gastroenterol. 2003;98:1494–1499.
5. Wysowski DK, Nourjah P, Swartz L. Bleeding complications with warfarin use: a prevalent adverse effect resulting in regulatory action. Arch Intern Med. 2007;167:1414–1419.
6. Theocharis GJ, Thomopoulos KC, Sakellaropoulos G, Katsakoulis E, Nikolopoulou V. Changing trends in the epidemiology and clinical outcome of acute upper gastrointestinal bleeding in a defined geographical area in Greece. J Clin Gastroenterol. 2008;42:128–133.
7. Laine L. Review article: gastrointestinal bleeding with low-dose aspirin—What’s the risk? Aliment Pharmacol Ther. 2006;24:897–908.
8. Coleman CI, Sobieraj DM, Winkler S, et al. Effect of pharmacological therapies for stroke prevention on major gastrointestinal bleeding in patients with atrial fibrillation. Int J Clin Pract. 2012;66:53–63.
9. Garcia Rodriguez LA, Lin KJ, Hernandez-Diaz S, Johansson S. Risk of upper gastrointestinal bleeding with low-dose acetylsalicylic acid alone and in combination with clopidogrel and other medications. Circulation. 2011;123:1108–1115.
10. Abraham NS, Hartman C, Richardson P, Castillo D, Street RL Jr, Naik AD. Risk of lower and upper gastrointestinal bleeding, transfusions, and hospitalizations with complex antithrombotic therapy in elderly patients. Circulation. 2013;128:1869–1877.
11. Boonpongmanee S, Fleischer DE, Pezzullo JC, et al. The frequency of peptic ulcer as a cause of upper-GI bleeding is exaggerated. Gastrointest Endosc. 2004;59:788–794.
12. Ahsberg K, Hoglund P, Stael von Holstein C. Mortality from peptic ulcer bleeding: the impact of comorbidity and the use of drugs that promote bleeding. Aliment Pharmacol Ther. 2010;32:801–810.
13. Lanas A, Aabakken L, Fonseca J, et al. Clinical predictors of poor outcomes among patients with nonvariceal upper gastrointestinal bleeding in Europe. Aliment Pharmacol Ther. 2011;33:1225–1233.
14. Sostres C, Lanas A. Should prophylactic low-dose aspirin therapy be continued in peptic ulcer bleeding? Drugs. 2011;71:1–10.
15. Sung JJ, Lau JY, Ching JY, et al. Continuation of low-dose aspirin therapy in peptic ulcer bleeding: a randomized trial. Ann Intern Med. 2010;152:1–9.
16. Qureshi W, Mittal C, Patsias I, et al. Restarting anticoagulation and outcomes after major gastrointestinal bleeding in atrial fibrillation. Am J Cardiol. 2014;113:662–668.
17. Mose H, Larsen M, Riis A, Johnsen SP, Thomsen RW, Sorensen HT. Thirty-day mortality after peptic ulcer bleeding in hospitalized patients receiving low-dose aspirin at time of admission. Am J Geriatr Pharmacother. 2006;4:244–250.
18. Ortiz V, Ortuno J, Rodriguez-Soler M, Iborra M, Garrigues V, Ponce J. Outcome of non-variceal acute upper gastrointestinal bleeding in patients with antithrombotic therapy. Digestion. 2009;80:89–94.
19. Taha AS, Angerson WJ, Knill-Jones RP, Blatchford O. Clinical outcome in upper gastrointestinal bleeding complicating low-dose aspirin and antithrombotic drugs. Aliment Pharmacol Ther. 2006;24:633–636.
20. Abu Daya H, Eloubeidi M, Tamim H, et al. Opposing effects of aspirin and anticoagulants on morbidity and mortality in patients with upper gastrointestinal bleeding. J Dig Dis. 2014;15:283–292.
21. Rotondano G, Cipolletta L, Koch M, et al. Predictors of favourable outcome in non-variceal upper gastrointestinal bleeding: implications for early discharge? Dig Liver Dis. 2014;46:231–236.
22. Sung JJ, Tsoi KK, Ma TK, Yung MY, Lau JY, Chiu PW. Causes of mortality in patients with peptic ulcer bleeding: a prospective cohort study of 10,428 cases. Am J Gastroenterol. 2010;105:84–89.
23. Marmo R, Koch M, Cipolletta L, et al. Predicting mortality in non-variceal upper gastrointestinal bleeders: validation of the Italian PNED Score and Prospective Comparison with the Rockall Score. Am J Gastroenterol. 2010;105:1284–1291.
24. Sorensen HT, Mellemkjaer L, Blot WJ, et al. Risk of upper gastrointestinal bleeding associated with use of low-dose aspirin. Am J Gastroenterol. 2000;95:2218–2224.
25. Hallas J, Dall M, Andries A, et al. Use of single and combined antithrombotic therapy and risk of serious upper gastrointestinal bleeding: population based case-control study. BMJ. 2006;333:726.
26. Hreinsson JP, Kalaitzakis E, Gudmundsson S, Bjornsson ES. Upper gastrointestinal bleeding: incidence, etiology and outcomes in a population-based setting. Scand J Gastroenterol. 2013;48:439–447.
27. Crooks CJ, West J, Card TR. Comorbidities affect risk of nonvariceal upper gastrointestinal bleeding. Gastroenterology. 2013;144:1384–1393, 1393 e1381–1382; quiz e1318–1389.
28. Barkun AN, Bardou M, Kuipers EJ, et al. International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med. 2010;152:101–113.
29. Gerstein NS, Schulman PM, Gerstein WH, Petersen TR, Tawil I. Should more patients continue aspirin therapy perioperatively? Clinical impact of aspirin withdrawal syndrome. Ann Surg. 2012;255:811–819.
30. John BK, Arramraju S, Shalomov A, Sison C, Rubin M. Antiplatelet agents do not impact the hospital course in patients with gastrointestinal bleeding. J Clin Gastroenterol. 2011;45:583–589.
31. Choudari CP, Rajgopal C, Palmer KR. Acute gastrointestinal haemorrhage in anticoagulated patients: diagnoses and response to endoscopic treatment. Gut. 1994;35:464–466.
32. Ahsberg K, Hoglund P, Kim WH, von Holstein CS. Impact of aspirin, NSAIDs, warfarin, corticosteroids and SSRIs on the site and outcome of non-variceal upper and lower gastrointestinal bleeding. Scand J Gastroenterol. 2010;45:1404–1415.
33. Thomopoulos KC, Mimidis KP, Theocharis GJ, Gatopoulou AG, Kartalis GN, Nikolopoulou VN. Acute upper gastrointestinal bleeding in patients on long-term oral anticoagulation therapy: endoscopic findings, clinical management and outcome. World J Gastroenterol. 2005;11:1365–1368.
34. Chiu PW, Joeng HK, Choi CL, Kwong KH, Ng EK, Lam SH. Predictors of peptic ulcer rebleeding after scheduled second endoscopy: clinical or endoscopic factors? Endoscopy. 2006;38:726–729.
35. Laine L, Peterson WL. Bleeding peptic ulcer. N Engl J Med. 1994;331:717–727.
36. Elmunzer BJ, Young SD, Inadomi JM, Schoenfeld P, Laine L. Systematic review of the predictors of recurrent hemorrhage after endoscopic hemostatic therapy for bleeding peptic ulcers. Am J Gastroenterol. 2008;103:2625–2632; quiz 2633.
37. Wong GL, Wong VW, Chan Y, et al. High incidence of mortality and recurrent bleeding in patients with Helicobacter pylori-negative idiopathic bleeding ulcers. Gastroenterology. 2009;137:525–531.
38. Rubin TA, Murdoch M, Nelson DB. Acute GI bleeding in the setting of supratherapeutic international normalized ratio in patients taking warfarin: endoscopic diagnosis, clinical management, and outcomes. Gastrointest Endosc. 2003;58:369–373.