4.3 Article

Risk factors for gastrointestinal bleeding in patients with cerebral infarction after dual antiplatelet therapy

Journal

CLINICAL NEUROLOGY AND NEUROSURGERY
Volume 231, Issue -, Pages -

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ELSEVIER
DOI: 10.1016/j.clineuro.2023.107802

Keywords

Cerebral infarction; Aspirin; Clopidogrel; Gastrointestinal bleeding; Risk factor

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This study investigated the risk factors for gastrointestinal bleeding in patients with cerebral infarction after dual antiplatelet therapy. Cerebral infarction patients who received dual antiplatelet therapy between January 2019 and December 2021 in Nanchang University Affiliated Ganzhou Hospital were included. Propensity score matching was used to compare the bleeding and nonbleeding groups. Conditional logistic regression analysis identified long-term use of aspirin and severity of cerebral infarction as risk factors for gastrointestinal bleeding, while the use of PPIs was found to be a protective factor.
Background: To investigate the risk factors for gastrointestinal bleeding in patients with cerebral infarction after dual antiplatelet therapy.Methods: Cerebral infarction patients who received dual antiplatelet therapy during January 2019 and December 2021 in Nanchang University Affiliated Ganzhou Hospital were included. Patients were divided into a bleeding group and a nonbleeding group. Propensity score matching was used to match the data between the two groups. The risk factors for cerebral infarction with gastrointestinal bleeding after receiving dual antiplatelet therapy were analyzed by conditional logistic regression.Results: There were 2370 cerebral infarction patients who received dual antiplatelet therapy included in the study. There were significant differences between the bleeding group and the nonbleeding group in terms of sex, age, smoking, drinking, hypertension, coronary heart disease, diabetes and peptic ulcer before matching. After matching, 85 patients were included in the bleeding group and nonbleeding group, and there was no significant difference between the two groups in terms of sex, age, smoking, drinking, previous cerebral infarction, hy-pertension, coronary heart disease, diabetes, gout or peptic ulcer. Conditional logistic regression analysis showed that long-term use of aspirin and severity of cerebral infarction were risk factors for gastrointestinal bleeding in cerebral infarction patients receiving dual antiplatelet therapy, whereas the use of PPI was a protective factor against gastrointestinal bleeding.Conclusions: Long-term use of aspirin and severity of cerebral infarction are risk factors for gastrointestinal bleeding in cerebral infarction patients receiving dual antiplatelet therapy. The use of PPIs could reduce the risk of gastrointestinal bleeding.

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