95077 20210902121747.0 doi 10.3390/jcm9051526 sideral 118738 ART-2020-118738 eng Laredo, Viviana No differences in gastrointestinal bleeding risk among clopidogrel-, ticagrelor-, or prasugrel-based dual antiplatelet therapy 2020 Access copy available to the general public Unrestricted 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. info:eu-repo/semantics/openAccess by http://creativecommons.org/licenses/by/3.0/es/ 4.241 2020 MEDICINE, GENERAL & INTERNAL 39 / 169 = 0.231 2020 Q1 T1 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Sostres, Carlos Universidad de Zaragoza (orcid)0000-0001-7466-3876 Garcia, Sandra Carrera-Lasfuentes, Patricia Revilla-Marti, Pablo Lanas, Ángel Universidad de Zaragoza (orcid)0000-0001-5932-2889 1007 610 Universidad de Zaragoza Dpto. Medicina, Psiqu. y Derm. Area Medicina 9, 5 (2020), 1526 [10 pp.] J. clin.med. JOURNAL OF CLINICAL MEDICINE 2077-0383 641824 http://zaguan.unizar.es/record/95077/files/texto_completo.pdf Versión publicada 480456 http://zaguan.unizar.es/record/95077/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:95077 articulos driver 2021-09-02-09:47:05 ARTICLE