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- W2922509568 abstract "Introduction: The relative risk of gastrointestinal bleeding in patients with underlying cirrhosis who require antiplatelet agents remains unclear. Many patients with cirrhosis have comorbid diseases that require antiplatelet therapy, such as those undergoing coronary stenting. Our aim was to evaluate the risk gastrointestinal bleeding in patients with underlying cirrhosis who were taking aspirin or aspirin and clopidogrel as compared to a control group of patients with cirrhosis who were not an any antiplatelet agents. Methods: Using the institutional electronic medical record we identified 131 patients with a confirmed diagnosis of cirrhosis, between 2006-2013, who received either no antiplatelet therapy, aspirin, or aspirin and clopidogrel. Primary outcomes were GI bleed and mortality. Results: Of the 131 cirrhotic patients, 46 were not on any antiplatelet agents (controls), 43 received aspirin therapy alone and 42 received aspirin and clopidogrel (cases). In multivariate analysis, comparison of medication groups against GI bleed reached statistical significance (p-value 0.01). Pairwise, control vs. asprin therapy alone was not statistically significant (p-value 1.0). In addition, aspirin vs. aspirin and clopidogrel was not statistically significant (p-value 0.11). However, control vs. aspirin and clopidogrel reached statistical significance (p-value 0.01). The adjusted odds ratio for GI bleed for aspirin and clopidogrel vs. control group was 4.8 (95% CI 1.69-13.60). There was no statistically significant difference in mortality between the three groups (p-value 0.11). Conclusion: The risk of GI bleeding in cirrhotic patients on dual anti-platlet therapy was almost 5x higher compared to their control counterparts. The use of aspirin alone does not appear to significantly increase the risk of GI bleeding. This study emphysises the importance of limiting the duration of dual antiplatelet therapy to the shortest therapeutic interval in patients with underlying cirrhosis. The increased risk of GI bleed for patients on aspirin and clopidogrel does not translate to increased mortality.950_A Figure 1 No Caption available.950_B Figure 2 No Caption available." @default.
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- W2922509568 date "2018-10-01" @default.
- W2922509568 modified "2023-09-23" @default.
- W2922509568 title "The Risk of Gastrointestinal Bleeding Is Higher in Patients With Underlying Cirrhosis on Dual Antiplatelet Therapy" @default.
- W2922509568 doi "https://doi.org/10.14309/00000434-201810001-00950" @default.
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