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학술저널
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거트앤리버 발행위원회 Gut and Liver Gut and Liver 제6권 제4호
발행연도
2012.1
수록면
423 - 426 (4page)

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Background/Aims: Antithrombotic/nonsteroidal antiinflammatory drug (NSAID) therapies increase the incidence of upper gastrointestinal bleeding. The features of hemorrhagic peptic ulcer disease in patients receiving antithrombotic/NSAID therapies were investigated. Methods: We investigated the medical records of 485 consecutive patients who underwent esophagogastroduodenoscopy and were diagnosed with hemorrhagic gastroduodenal ulcers. The patients treated with antithrombotic agents/NSAIDs were categorized as the antithrombotic therapy (AT) group (n=213). The patients who were not treated with antithrombotics/NSAIDs were categorized as the control (C) group (n=263). The clinical characteristics were compared between the groups. Results: The patients in the AT group were significantly older than those in the C group (p<0.0001). The hemoglobin levels before/without transfusion were significantly lower in the AT group (8.24±2.41 g/dL) than in the C group (9.44±2.95 g/dL) (p<0.0001). After adjusting for age, the difference in the hemoglobin levels between the two groups remained significant (p=0.0334). The transfusion rates were significantly higher in the AT group than in the C group (p=0.0002). However, the outcome of endoscopic hemostasis was similar in the AT and C groups. Conclusions: Patients with hemorrhagic peptic ulcers receiving antithrombotic/NSAID therapies were exposed to a greater risk of severe bleeding that required transfusion but were still treatable by endoscopy.
#Peptic ulcer #Hemorrhagic ulcer #Antithrombotic therapy #Anti-inflammatory agents #non-steroidal #Endoscopic hemostasis

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참고문헌 신청
Smith SC Jr / 2006 / AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute / Circulation 113 : 2363 ~ 2372 | 2. [학술지(정기간행물)] - Yeomans ND / 2005 / Prevalence and incidence of gastroduodenal ulcers during treatment with vascular protective doses of aspirin / Aliment Pharmacol Ther 22 : 795 ~ 801 | 3. [학술지(정기간행물)] - Sakamoto C / 2006 / Case-control study on the association of upper gastrointestinal bleeding and nonsteroidal anti-inflammatory drugs in Japan / Eur J Clin Pharmacol 62 : 765 ~ 772 | 4. [학술지(정기간행물)] - García Rodríguez LA / 2001 / Association between aspirin and upper gastrointestinal complications: systematic review of epidemiologic studies / Br J Clin Pharmacol 52 : 563 ~ 571 | 5. [학술지(정기간행물)] - McQuaid KR / 2006 / Systematic review and meta-analysis of adverse events of low-dose aspirin and clopidogrel in randomized controlled trials / Am J Med 119 : 624 ~ 638 | 6. [학술지(정기간행물)] - Anderson JL / 2007 / ACC/AHA 2007 guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 2002 guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction): developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons: endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine / Circulation 116 : e148 ~ e304 | 7. [학술지(정기간행물)] - Hallas J / 2006 / Use of single and combined antithrombotic therapy and risk of serious upper gastrointestinal bleeding: population based case-control study / BMJ 333 : 726 ~ | 8. [학술지(정기간행물)] - Delaney JA / 2007 / Drug drug interactions between antithrombotic medications and the risk of gastrointestinal bleeding / CMAJ 177 : 347 ~ 351 | 9. [학술지(정기간행물)] - Sørensen HT / 2000 / Risk of upper gastrointestinal bleeding associated with use of low-dose aspirin / Am J Gastroenterol 95 : 2218 ~ 2224 | 10. [학술지(정기간행물)] - Bhatt DL / 2008 / ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents / Circulation 118 : 1894 ~ 1909 | 11. [학술지(정기간행물)] - Niv Y / 2005 / Endoscopy in asymptomatic minidose aspirin consumers / Dig Dis Sci 50 : 78 ~ 80 google schola

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