From anti-inflammatory and anti-platelet effects to gastroprotection

This is an automatically generated default intro template – please do not edit.

	Read full article
Article Title:	From anti-inflammatory and anti-platelet effects to gastroprotection
Authors:	Ioan Demeter
Affiliation:	Emergency County Hospital, Deva, Romania
Abstract:	Objectives. The study focuses both on the aspects of the anti-platelet – anti-inflammatory treatment in certain cardiovascular disorders and on the major problem deriving from the chronic use of this medication, problems represented by digestive disorders ranging from simple abdominal pain to gastroduodenal ulcer, upper digestive hemorrhage, perforation and stenosis, as well as on the measures of gastric protection required in such situations. Possible and definite risk factors responsible for the development of post-therapeutic side effects have also been analyzed. Materials and methods. The study was conducted on 526 patients with various cardiovascular disorders, who were administered minimum-effective doses of aspirin or Clopidogrel (anti-platelet effect). The patients were divided into categories according to their age, risk factors, and the development of possible complications (mainly drug-induced gastrointestinal complications). The study group was monitored clinically, biologically and endoscopically. Results. The study focuses on two major aspects: on the one hand, the obvious benefits of the anti-platelet treatment, also indirectly through the occurrence or avoidance of major cardiovascular events and, on the second hand, the risks of anti-platelet treatment in developing gastrointestinal disorders, erosive esophagitis, erosive ulcer, erosive gastroduodenitis, gastroduodenal ulcer, upper gastro-intestinal bleeding (UGIB). Discussions. The study reveals the benefits of anti-platelet treatment, benefits that definitely exceed the risks of gastrointestinal complications in a certain category of patients with various clinical manifestations of cardiovascular disorders. The results obtained by using anti-platelet treatment are similar to those published in literature. Conclusions. The benefits of anti-platelet therapy exceed the risks of gastrointestinal hemorrhagic complications in many clinical situations characterized by moderate- or high- risk vascular or occlusive events. The association of risk factors increases the rate of side effects, mainly of gastrointestinal ones. The prevention of side effects induced by anti-platelet – anti-inflammatory treatment requires therapeutic gastroprotective measures.
Keywords:	anti-platelet, therapeutic benefits, risk factors, side effects, gastroprotection
References:	Nakashima S, Arai 5, Mizuno Y, Yoshino K, Ando 5, Nakamura Y, Sugawara K, Koike M, Saito E. A Clinical Study of Japanese Patients with Ulcer Induced by Low Dose Aspirin and Other Non Steroidal Antiinflamatory Drugs. Aliment Pharmacol Ther 2005 Hernandez-Diaz S, Garcia Rodriguez LA. Cardioprotective aspirin users and their excess risk of upper gastro-intestinal complication. BMC Med 2006; 4:22. Hallas J, Dall M, Andries A, et al. Use of single and combined antithrombotic therapy and risk of serious upper gastro-intestinal bleeding: population based case-control study. BMJ 2006; 333:726 CAPRIE Steering Committee. Effects of Clopidogrel in addition to aspirin in Patients with Acute Coronary Syndromes without ST Segment Elevation. N Engl. J. Med 2001 Expert consensus about the usage of anti-platelet agents in atherosclerotic cardiovascular disease. European Heart Journal 2004 vol. 25; nr.2; 156-181 L. Gherasim. Treatise of internal medicine. Vol. II and III. Ed. Med. 2003 J.Am. Coll. Cardiol. Naproxane interfered with the inhibitory effect of aspirin on platelet COX1 activity and function. 2005, 45.1 295-301 Husted S. Evidence-based prescribing and adherence to anti-platelet therapy-how much difference do they make to patients with atherothrombosis? Int J Cardol 2009; 134: 150-159 Wiviott SD, Braunwald E, McCabeCH, et al. Prasugrel versus Clopidogrel in patients with acute coronary syndromes. N Engl J Med 2007; 357:2001-2015 Andreotti F, Testa L, Biondi-Zoccai GG, Crea F. Aspirin plus warfarin compared to aspirin alone after acute coronary syndromes: an updated and comprehensive meta-analysis of 25,307 patients. Eur Heart J 2006; 27: 519-526.
*Correspondence:	Demeter Ioan, Doctor of internal medicine, Specialist in Allergo-Immunology,Competence in Digestive Endoscopy Address: Ioan Demeter, str. 22 Decembrie, Emergency County Hospital, Deva, Romania, Tel: +40 722 564 003. Fax: +40 254 212 516 E-mail: demeter.ioan@gmail.com