Management of low-dose aspirin and clopidogrel in clinical practice: a gastrointestinal perspective

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• 作者：Angel Lanas ; Carla J. Gargallo
• 关键词：Low ; dose aspirin ; Clopidogrel ; Gastrointestinal injury ; Proton pump inhibitors
• 刊名：Journal of Gastroenterology
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：50
• 期：6
• 页码：626-637
• 全文大小：606 KB
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  22.Lanas A, Serrano P, Bajador E, et al. Evidence of aspirin use in both upper and lower
• 作者单位：Angel Lanas (1) (2) (3) (4)
  Carla J. Gargallo (1)
  
  1. Service of Digestive Diseases, University Hospital, Saragossa, Spain
  2. University of Zaragoza, Saragossa, Spain
  3. IIS Aragón, Saragossa, Spain
  4. CIBERehd, Saragossa, Spain
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Gastroenterology
  Oncology
  Surgical Oncology
  Hepatology
  Internal Medicine
  Colorectal Surgery
  
• 出版者：Springer Japan
• ISSN：1435-5922

文摘

Low-dose aspirin, alone or combined with other antiplatelet agents, is increasingly prescribed for cardiovascular prevention. However, the cardiovascular benefits should be evaluated together with the gastrointestinal risks. Low-dose aspirin is associated with upper and lower gastrointestinal injury, although lower gastrointestinal effects are poorly characterized. This gastrointestinal risk differs among antiplatelets drugs users. The most important risk factors are history of peptic ulcer, older age, and concomitant use of non-steroidal anti-inflammatory drugs or dual antiplatelet therapy. Effective upper gastrointestinal prevention strategies are available and should be used in at-risk patients taking low-dose aspirin or clopidogrel. Proton pump inhibitors seem to be the best gastroprotective agents, whereas the benefits of Helicobacter pylori eradication are still unclear. Low-dose aspirin has additional effects in the gastrointestinal tract. A large body of evidence indicates that it can protect against different cancers, in particular colorectal cancer. This effect could modify the future indications for use of low-dose aspirin and the risk–benefit balance.