Influence of dual antiplatelet drugs on risk of upper gastrointestinal hemorrhage in patients with car‐dio‐and cerebrovascular diseases／ / 心血管康复医学杂志

ABSTRACT

To explore influence of dual antiplatelet drugs on risk of upper gastrointestinal hemorrhage (UGIH) in patients with cardio‐and cerebrovascular diseases (CCVD).Methods : Clinical data of 963 CCVD pa‐tients ,who received dual antiplatelet medication ,were retrospectively analyzed .With presence of UGIH as depend‐ent variable ,clinical factors including age ,gender ,history of smoking ,drinking ,gastrointestinal hemorrhage or ul‐cer ,Helicobacter pylori (HP) infection ,combined use of proton pump inhibitor (PPI ) etc .as independent varia‐bles ;upper gastrointestinal hemorrhage condition under different clinical factors were compared .Logistic multi‐fac‐tor regression analysis was used to analyze independent risk factors of UGIH treated by dual antiplatelet drugs in CCVD patients .Results : UGIH occurred in 68 cases (7.06%) among the 963 patients .Single factor analysis indica‐ted that old age (≥65 years old) ,history of smoking ,drinking ,gastrointestinal hemorrhage or ulcer ,HP infection and no combined use of PPI lead to a significant higher incidence rate of UGIH ,P＝0.001 all ;Logistic multi‐factor regression analysis indicated that old age (≥65 years old ) ,smoking ,gastrointestinal hemorrhage or ulcer history and HP infection were independent risk factors for UGIH (OR＝1.860～5. 730 , P＜0. 05 or ＜0.01) ,while com‐bined used of PPI was its independent protective factor (OR＝0. 116 , P＝0.001).Conclusion : For CCVD patients with old age ,history of smoking ,gastrointestinal hemorrhage or ulcer and HP infection ,it is necessary to be cau‐tious for incidence of UGIH and receive combined use of PPI early ,which may help to reduce risk of UGIH .