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Gastrointestinal bleeding during low-dose aspirin administration for prevention of arterial occlusive events. A

R Stalnikowicz-Darvasi1

  • 1Department of Internal Medicine, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.

Journal of Clinical Gastroenterology
|July 1, 1995
PubMed

Insights

Low-dose aspirin (75-325 mg/day) is recommended for preventing heart attacks and strokes. However, this daily aspirin use increases gastrointestinal bleeding risk by 1.5 times compared to placebo.

Area of Science:

  • Cardiovascular Medicine
  • Gastroenterology
  • Pharmacology

Background:

  • Low-dose aspirin is widely used for primary and secondary prevention of cardiovascular events like myocardial infarction.
  • It is also recommended for maintaining aortocoronary bypass patency and reducing risks associated with cerebrovascular and ischemic events.
  • While beneficial, aspirin, even at anti-inflammatory doses, is linked to gastrointestinal bleeding risks.

Purpose of the Study:

  • To evaluate the role of low-dose aspirin in gastrointestinal bleeding.
  • To quantify the increased risk of bleeding associated with low-dose aspirin therapy.

Main Methods:

  • A meta-analysis was conducted, combining results from nine studies.
  • Studies included focused on the prevention of ischemic, thromboembolic, or cerebrovascular events using low-dose aspirin.
  • The primary outcome assessed was the occurrence of gastrointestinal bleeding.

Main Results:

  • Patients treated with low-dose aspirin (75-325 mg/day) showed a 1.52 times higher odds of experiencing bleeding compared to placebo (95% CI 1.32-1.75).
  • The monthly probability of gastrointestinal bleeding per 1,000 patients on low-dose aspirin ranged from 0 to 2.1.

Conclusions:

  • Low-dose aspirin therapy significantly increases the risk of gastrointestinal bleeding.
  • Clinicians should carefully weigh the benefits of low-dose aspirin against the increased gastrointestinal bleeding risk in patients.

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