کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3291917 1209768 2016 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Risks of Bleeding Recurrence and Cardiovascular Events With Continued Aspirin Use After Lower Gastrointestinal Hemorrhage
ترجمه فارسی عنوان
خطرات تکرار خونریزی و حوادث قلبی عروقی با استفاده مداوم آسپرین پس از خونریزی دستگاه گوارش تحتانی
کلمات کلیدی
عوارض؛ روده؛ آسپرین، فاصله اطمینان؛ GI، دستگاه گوارش SHR، نسبت خطر توزیع زیرزمینی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های گوارشی
چکیده انگلیسی

Background & AimsIt is not clear whether use of low-dose aspirin should be resumed after an episode of lower gastrointestinal (GI) bleeding. We assessed the long-term risks of recurrent lower GI bleeding and serious cardiovascular outcomes after aspirin-associated lower GI bleeding.MethodsWe performed a retrospective study of patients diagnosed with lower GI bleeding (documented melena or hematochezia and absence of upper GI bleeding) from January 1, 2000 through December 31, 2007 at the Prince of Wales Hospital in Hong Kong. Using the hospital registry, we analyzed data from 295 patients on aspirin and determined their outcomes during a 5-year period. Outcomes included recurrent lower GI bleeding, serious cardiovascular events, and death from other causes, as determined by an independent, blinded adjudication committee. Outcomes were compared between patients assigned to the following groups based on cumulative duration of aspirin use: <20% of the follow-up period (121 nonusers) vs ≥50% of the observation period (174 aspirin users).ResultsWithin 5 years, lower GI bleeding recurred in 18.9% of aspirin users (95% confidence interval [CI], 13.3%−25.3%) vs 6.9% of nonusers (95% CI, 3.2%−12.5%; P = .007). However, serious cardiovascular events occurred in 22.8% of aspirin users (95% CI, 16.6%−29.6%) vs 36.5% of nonusers (95% CI, 27.4%−45.6%; P = .017), and 8.2% of aspirin users died from other causes (95% CI, 4.6%−13.2%) vs 26.7% of nonusers (95% CI, 18.7%−35.4%; P = .001). Multivariable analysis showed that aspirin use was an independent predictor of rebleeding, but protected against cardiovascular events and death.ConclusionsAmong aspirin users with a history of lower GI bleeding, continuation of aspirin is associated with an increased risk of recurrent lower GI bleeding, but reduced risk of serious cardiovascular events and death.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Gastroenterology - Volume 151, Issue 2, August 2016, Pages 271–277
نویسندگان
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