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항혈소판제 병합요법이 소화성 궤양 발생에 미치는 영향
Clinical Impact of Dual Antiplatelet Therapy on Peptic Ulcer Disease

대한소화기학회지 2014년 64권 2호 p.81 ~ p.86

안대건(Ahn Dae-Geon) - 중앙대학교 의과대학 내과학교실
김범진(Kim Beom-Jin) - 중앙대학교 의과대학 내과학교실
김정욱(Kim Jeong-Wook) - 중앙대학교 의과대학 내과학교실
김재규(Kim Jae-Kyu) - 중앙대학교 의과대학 내과학교실

Abstract

Background/Aims: Increased incidence of coronary artery disease has led to the increased use of dual antiplatelet therapy composed of aspirin and clopidogrel. We investigated the incidence of gastrointestinal complications in patients who received single or dual antiplatelet therapy and analyzed their clinical characteristics in order to predict the prognostic factors.

Methods: Between January 2009 and December 2011, we retrospectively reviewed the medical records of patients who underwent coronary angiography at Chung-Ang University Hospital (Seoul, Korea). One hundred and ninety-four patients were classified into two groups: aspirin alone group and dual antiplatelet group. Clinical characteristics, past medical history, and presence of peptic ulcer were analyzed.

Results: During the follow-up period, 11 patients had duodenal ulcer; the event rate was 2.02% in the aspirin alone group and 9.47% in the dual antiplatelet group (hazard ratio [HR] 5.24, 95% CI 1.03-26.55, p＜0.05). There was no significant difference in the rate of significant upper gastrointestinal bleeding: 0% vs. 4.2% (p=0.78). In patients who received proton pump inhibitor (PPI), 24 patients had gastric ulcer; the event rate was significantly different between the two groups: 4.87% vs. 22.98% (HR 3.40, 95% CI 1.02-11.27, p＜0.05).

Conclusions: Dual antiplatelet groups had a higher incidence of duodenal ulcers without significant bleeding compared with the aspirin alone group. In patients who received PPI, the dual antiplatelet therapy group had a higher incidence of gastric ulcers without significant bleeding compared with the aspirin alone group. Therefore, physicians must pay attention to high risk groups who receive dual antiplatelet therapy and aggressive diagnostic endoscopy should also be considered.

키워드

Platelet aggregation inhibitors, Endoscopes, Gastrointestinal hemorrhage, Peptic ulcer

KMID : 0614620140640020081

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유효성결과(Recomendation)

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DOI

KCD코드

ICD 03

건강보험코드

항혈소판제 병합요법이 소화성 궤양 발생에 미치는 영향 Clinical Impact of Dual Antiplatelet Therapy on Peptic Ulcer Disease

Abstract

키워드

항혈소판제 병합요법이 소화성 궤양 발생에 미치는 영향
Clinical Impact of Dual Antiplatelet Therapy on Peptic Ulcer Disease