Next Article in Journal
Comparison of the Characteristics and Outcomes of Coronavirus Disease 2019 in Different Types of Family Infections in Taiwan
Previous Article in Journal
Comparative Safety of Bevacizumab, Ranibizumab, and Aflibercept for Treatment of Neovascular Age-Related Macular Degeneration (AMD): A Systematic Review and Network Meta-Analysis of Direct Comparative Studies
Previous Article in Special Issue
Non-Vitamin K Antagonist Oral Anticoagulants and the Gastrointestinal Bleeding Risk in Real-World Studies
Open AccessArticle

No Differences in Gastrointestinal Bleeding Risk among Clopidogrel-, Ticagrelor-, or Prasugrel-Based Dual Antiplatelet Therapy

1
Department of Gastroenterology, University Clinic Hospital Lozano Blesa, 50009 Zaragoza, Spain
2
CIBERehd, 28029 Madrid, Spain
3
IIS Aragón, 50009 Zaragoza, Spain
4
Department of Cardiology, University Clinic Hospital Lozano Blesa, 50009 Zaragoza, Spain
5
Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, 50009 Zaragoza, Spain
*
Authors to whom correspondence should be addressed.
Viviana Laredo and Carlos Sostres are both first authors and corresponding authors of this study.
J. Clin. Med. 2020, 9(5), 1526; https://doi.org/10.3390/jcm9051526
Received: 17 April 2020 / Revised: 9 May 2020 / Accepted: 13 May 2020 / Published: 18 May 2020
(This article belongs to the Special Issue New Trends and Advances in Non-Variceal Gastrointestinal Bleeding)
The risk for gastrointestinal bleeding from dual antiplatelet therapy (DAPT) with new antiplatelets (prasugrel/ticagrelor) compared to clopidogrel is unclear. Aim: To determine the risk and type of major (gastrointestinal bleeding requiring hospitalization) and minor (anemia and iron deficiency) gastrointestinal events with different types of DAPT. Methods: Retrospective observational cohort study of patients who started DAPT after percutaneous coronary intervention. Follow-up was censored after 12 months of DAPT, when a major gastrointestinal event occurred, or when DAPT was discontinued. Results: Among 1,327 patients (54.03% were treated with clopidogrel-based DAPT, 38.13% with ticagrelor-based DAPT, and 7.84% with prasugrel-based DAPT), 29.5% had at least one gastrointestinal event. Patients taking clopidogrel-DAPT were older, with more comorbidities, and higher gastrointestinal risk compared to those taking other DAPT regimens. Adjusted hazard ratios (HRs) showed no between-group differences in the risk for major (clopidogrel vs. new antiplatelets: HR 0.996; 95% confidence interval 0.497–1.996) and minor (HR 0.920; 0.712–1.189) gastrointestinal events. Most patients received proton pump inhibitors while on DAPT (93.3%) and after withdrawal (83.2%). Conclusion: Prasugrel- or ticagrelor-based DAPT was not associated with increased gastrointestinal bleeding risk when compared to clopidogrel-DAPT. New antiplatelets do not necessarily need to be restricted to patients with low gastrointestinal risk. View Full-Text
Keywords: ticagrelor; prasugrel; gastrointestinal bleeding; dual antiplatelet therapy ticagrelor; prasugrel; gastrointestinal bleeding; dual antiplatelet therapy
Show Figures

Figure 1

MDPI and ACS Style

Laredo, V.; Sostres, C.; García, S.; Carrera-Lasfuentes, P.; Revilla-Marti, P.; Lanas, Á. No Differences in Gastrointestinal Bleeding Risk among Clopidogrel-, Ticagrelor-, or Prasugrel-Based Dual Antiplatelet Therapy. J. Clin. Med. 2020, 9, 1526.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Search more from Scilit
 
Search
Back to TopTop