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Scandinavian Journal of Gastroenterology Volume 57, 2022 - Issue 5
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Original Article

Discontinuing low-dose acetylsalicylic acid after gastrointestinal bleeding is associated with increased mortality

Sami Miilunpohjaa Heart Centre, Kuopio University Hospital, Kuopio, Finland;b Emergency Department, Kuopio University Hospital, Kuopio, FinlandCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0002-4631-9709View further author information
ORCID Icon,
Johanna Jyrkkäc Assessment of Pharmacotherapies, Finnish Medicines Agency, Kuopio, FinlandView further author information
,
Jussi M. Kärkkäinena Heart Centre, Kuopio University Hospital, Kuopio, Finland;d Department of Surgery, Kuopio University Hospital, Kuopio, FinlandView further author information
,
Helena Kastarinene Insurance Medicine Unit, The Social Insurance Institution of Finland, Kuopio, FinlandView further author information
,
Markku Heikkinenf Department of Medicine, Kuopio University Hospital, Kuopio, FinlandView further author information
,
Hannu Paajanend Department of Surgery, Kuopio University Hospital, Kuopio, Finland;g Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, FinlandView further author information
,
Tuomo Rantanend Department of Surgery, Kuopio University Hospital, Kuopio, Finland;g Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, FinlandView further author information
&
Juha Hartikainena Heart Centre, Kuopio University Hospital, Kuopio, Finland;g Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, FinlandORCID Iconhttps://orcid.org/0000-0003-0847-107XView further author information
ORCID Icon show all
Pages 618-624 | Received 31 Oct 2021, Accepted 03 Jan 2022, Published online: 18 Jan 2022

References

  • Thomopoulos KC, Vagenas KA, Vagianos CE, et al. Changes in aetiology and clinical outcome of acute upper gastrointestinal bleeding during the last 15 years. Eur J Gastroenterol Hepatol. 2004;16(2):177–182.
  • Malmi H, Kautiainen H, Virta LJ, et al. Incidence and complications of peptic ulcer disease requiring hospitalisation have markedly decreased in Finland. Aliment Pharmacol Ther. 2014;39(5):496–506.
  • Hreinsson JP, Kalaitzakis E, Gudmundsson S, et al. Upper gastrointestinal bleeding: incidence, etiology and outcomes in a population-based setting. Scand J Gastroenterol. 2013;48(4):439–447.
  • Higuchi T, Iwakiri R, Hara M, et al. Low-dose aspirin and comorbidities are significantly related to bleeding peptic ulcers in elderly patients compared with nonelderly patients in Japan. Intern Med. 2014;53(5):367–373.
  • Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. J Am Coll Cardiol. 2019;74(10):e177–e232.
  • Burger W, Chemnitius JM, Kneissl GD, et al. Low-dose aspirin for secondary cardiovascular prevention – cardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation – review and meta-analysis. J Intern Med. 2005;257(5):399–414.
  • McNeil JJ, Wolfe R, Woods RL, ASPREE Investigator Group, et al. Effect of aspirin on cardiovascular events and bleeding in the healthy elderly. N Engl J Med. 2018;379(16):1509–1518.
  • McNeil JJ, Nelson MR, Woods RL, ASPREE Investigator Group, et al. Effect of aspirin on all-cause mortality in the healthy elderly. N Engl J Med. 2018;379(16):1519–1528.
  • McNeil JJ, Woods RL, Nelson MR, ASPREE Investigator Group, et al. Effect of aspirin on disability-free survival in the healthy elderly. N Engl J Med. 2018;379(16):1499–1508.
  • Baigent C, Blackwell L, Collins R, Antithrombotic Trialists' (ATT) Collaboration, et al. Aspirin in the primary and secondary prevention of vascular disease: Collaborative Meta-analysis of individual participant data from randomised trials. Lancet. 2009;373(9678):1849–1860.
  • Biondi-Zoccai GG, Lotrionte M, Agostoni P, et al. A systematic review and meta-analysis on the hazards of discontinuing or not adhering to aspirin among 50,279 patients at risk for coronary artery disease. Eur Heart J. 2006;27(22):2667–2674.
  • Sung JJ, Lau JY, Ching JY, et al. Continuation of low-dose aspirin therapy in peptic ulcer bleeding: a randomized trial. Ann Intern Med. 2010;152(1):1–9.
  • Kim SY, Hyun JJ, Suh SJ, Jung SW, Jung YK, et al. Risk of vascular thrombotic events following discontinuation of antithrombotics after peptic ulcer bleeding. J Clin Gastroenterol. 2016;50(4):e40–e44.
  • Sundstrom J, Hedberg J, Thuresson M, et al. Low-dose aspirin discontinuation and risk of cardiovascular events: a Swedish nationwide, population-based cohort study. Circulation. 2017;136(13):1183–1192.
  • Zheng SL, Roddick AJ. Association of aspirin use for primary prevention with cardiovascular events and bleeding events: a systematic review and Meta-analysis. JAMA. 2019;321(3):277–287.
  • Luepker RV, Steffen LM, Duval S, et al. Population trends in aspirin use for cardiovascular disease prevention 1980–2009: the Minnesota heart survey. JAHA. 2015;4(12):e002320. DOI:https://doi.org/10.1161/JAHA.115.002320.
  • Siau K, Hannah JL, Hodson J, et al. Stopping antithrombotic therapy after acute upper gastrointestinal bleeding is associated with reduced survival. Postgrad Med J. 2018;94(1109):137–142.
  • Wang XX, Dong B, Hong B, et al. Long-term prognosis in patients continuing taking antithrombotics after peptic ulcer bleeding. WJG. 2017;23(4):723–729.
  • Derogar M, Sandblom G, Lundell L, et al. Discontinuation of low-dose aspirin therapy after peptic ulcer bleeding increases risk of death and acute cardiovascular events. Clin Gastroenterol Hepatol. 2013;11(1):38–42.
  • Laine L, Jensen DM. Management of patients with ulcer bleeding. Am J Gastroenterol. 2012;107(3):345–360; quiz 361. 60; quiz 361.
  • Gralnek IM, Stanley AJ, Morris AJ, et al. Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) guideline – update 2021. Endoscopy. 2021;53(3):300–332.
  • Sung JJ, Tsoi KK, Ma TK, et al. Causes of mortality in patients with peptic ulcer bleeding: a prospective cohort study of 10,428 cases. Am J Gastroenterol. 2010;105(1):84–89.

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