In aspirin users with a history of lower gastrointestinal bleeding, continued aspirin use increases risk of recurrent bleeding by almost 3-fold, but reduces risk of serious cardiovascular events by 40% and risk of death from other causes by 17%, researchers report in the August issue of Gastroenterology.
First author Francis K.L. Chan discusses the group’s findings in a video abstract.
They performed their retrospective study of 295 patients diagnosed with lower gastrointestinal bleeding using the registry from the Prince of Wales Hospital in Hong Kong, over a 5-year period.
Within 5 years, lower gastrointestinal bleeding recurred in 18.9% of aspirin users vs 6.9% of nonusers. However, serious cardiovascular events occurred in 22.8% of aspirin users vs 36.5% of nonusers. Of aspirin users, 8.2% died from other causes vs 26.7% of nonusers.
Multi-variable analysis showed that aspirin use was an independent predictor of rebleeding, but protected against cardiovascular events and death.
Chan et al conclude that the benefits of continuous aspirin therapy must be weighed against the risk of recurrent bleeding. Physicians should carefully evaluate each patients’ risk factors before resuming aspirin therapy.