Key result
Low-dose aspirin is linked to an ~80% increase in upper GI hemorrhage compared to NSAIDs.
Why the study?
Does the use of low-dose aspirin and anti-thrombotic drugs change the incidence of upper gastrointestinal haemorrhage over time compared to NSAIDs?
Observational (n=680)
No
Does the use of low-dose aspirin and anti-thrombotic drugs change the incidence of upper gastrointestinal haemorrhage over time compared to NSAIDs?
p-value: p=0.004
The rising incidence of upper gastrointestinal haemorrhage associated with low-dose aspirin and anti-thrombotic drugs parallels a decrease in cardiac mortality, highlighting the population-level trade-off between bleeding risk and cardiovascular benefit.
Highlights potential aspirin-related bleed-cardiac benefit trade-off; leaves open causal trends and net population impact.
BACKGROUND: Low-dose aspirin and other anti-thrombotic therapy has been increasingly used for vascular protection. AIM: To assess the possibility that the incidence of upper gastrointestinal blood loss has changed in subjects using these agents in comparison with non-steroidal anti-inflammatory drugs. METHODS: We studied the characteristics of all patients with acute upper gastrointestinal haemorrhage and attending a single hospital at 3 points over a 6-year period: 1996 (n = 204), 1999 (n = 224) and in 2002 (n = 252). RESULTS: The incidence of haemorrhage in subjects taking low-dose aspirin rose from 15 per 100 000 of the population per annum in 1996, to 18 in 1999 and 27 in 2002 (P = 0.004). The respective incidence in subjects taking other anti-thrombotic drugs was 4, 8, and 12 (P < 0.001). No significant change was detected in non-steroidal anti-inflammatory drug users. However, acute myocardial infarction mortality was 216 per 100 000 in 1996, 221 in 1999 and fell to 169 in 2002 (P < 0.001). CONCLUSIONS: The incidence of upper gastrointestinal haemorrhage in users of low-dose aspirin and other anti-thrombotic drugs has been steadily rising. This has been paralleled by a fall in cardiac mortality.
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Taha et al. (2005) conducted an observational in Acute upper gastrointestinal haemorrhage (n=680). Low-dose aspirin and other anti-thrombotic drugs vs. Non-steroidal anti-inflammatory drugs was evaluated on Incidence of upper gastrointestinal haemorrhage (p=0.004). The incidence of upper gastrointestinal haemorrhage in users of low-dose aspirin rose from 15 to 27 per 100,000 per annum over 6 years (P=0.004), with no significant change in NSAID users.
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