Risk factors analysis of upper gastrointestinal bleeding in elderly patients with aspirin and clopidogrel co-therapy / 中国医师进修杂志

ABSTRACT

Objective To explore the current occurrence of upper gastrointestinal bleeding (UGIB)in elderly patients and its possible risk factors and treatment program. Methods The clinical data of 758 elderly coronary heart disease patients with aspirin and clopidogrel co-therapy were collected, including past medical history,common condition,clinical medication,biochemical indicator and clinical turnover. The follow-up ended on the dates of a first occurrence of UGIB and death or after stopping co-therapy above 10 days. The follow-up time was 6 months. Results UGIB occurred in 48 patients,the occurrence rate was 6.3% (48/758). The occurrence rate of UGIB in proton pump inhibitor (PPI), H2-receptor antagonist (H2RA), gastric mucosa protective agents plus PPI, gastric mucosa protective agents plus H2RA and control was 3.7% (4/108),5.0% (12/240),1.4% (1/70),2.9% (3/102),11.8% (28/238). There were statistic differences in different methods (x2 = 18.63,P = 0.001). Conclusions The occurrence rate of UGIB combined with aspirin and clopidogrel co-therapy in elderly is high. Co-prescription with PPI and gastric mucosa protective agents is associated with a lower risk.