Anti-platelet Therapy and the Risk of Upper Gastrointestinal Bleeding

Abstract

Background: We aimed to determine the effects of anti-platelet drugs use on adverse outcomes in patients with non-variceal upper gastrointestinal bleeding (UGIB).

Materials and Methods: A historical cohort study was performed on patients with non-variceal UGIB admitted to a tertiary care hospital. Clinical outcomes were compared among users of aspirin and patients who did not receive aspirin. Adverse outcome variables consisted of re-bleeding, need for surgery, and death.

Results: Out of 271 patients (77.5% men, mean age 59.5±19.0 years) with non-variceal UGIB, 157 (57.9%) did not receive any anti-platelet drugs, 87 (32.1%) received only aspirin, and 27 (10.0%) received dual anti-platelet therapy. The frequency of adverse outcomes was significantly higher in patients who bled while not receiving anti-platelets (31.2% no anti-platelets, 12.6% single anti-platelet agent, and 14.8% on dual anti-platelets, p=0.002). A significant difference in the duration of admission was not found between the three groups (5.5±4.3 in patients with no anti-platelet drugs, 5.6±4.6 in patients received single anti-platelet agent, and 5.0±4.3 in patients received dual anti-platelets, p =0.84).

Conclusion: Patients with non-variceal UGIB while taking anti-platelet drugs had a lower rate of adverse outcomes compared with non-users of anti-platelets.