Ayşe ÇARLIOĞLU, Erkmen Mehtap UYAR, Aydın KARANFİL, Cansel TÜRKAY, Burak UZ

Düşük doz aspirin ve klopidogrel kullanımına bağlı gastrointestinal yan etkilerin değerlendirilmesi

Giriş ve amaç: Aspirin gastrointestinal sistemdeki olumsuz yan etkilerine rağmen kullanım kolaylığı, uzun yıllara giden bilgi birikimi ve maliyeti nedeniyle klinik kullanımda en etkili olan antiplatelet ajandır. Aspirin yerine kullanılabilecek diğer bir ilaç klopidogreldir. Biz de bu çalışmada aspirin ve klopidogrel kullanımı ile gastrointestinal yan etkilerin endoskopi, semptom skorlaması ve gastrointestinal kanama takibiyle değerlendirilmesini amaçladık. Gereç ve yöntem: Çalışmaya koroner arter hastalığı, serebrovasküler hastalık, diyabet, konjestif kalp yetmezliği, hipertansiyonu veya geçici iskemik atağı olan 34'ü kadın, 16'sı erkek, yaş ortalaması 59±10 olan toplam 50 hasta alındı. Bu hastalara randomize olarak aspirin 100 mg/gün veya klopidogrel 75 mg/gün verildi. Bulgular: Çalışmamızın sonuçları na göre düşük doz aspirin ya da klopidogrel kullanan hastalarda istatistiksel olarak kanama riski, semptom skoru ve endoskopik bulgularda anlamlı bir farklılık saptanmadı (P>0.5). Sonuç: Her iki ilaç da gastrointestinal yan etkiler açısından güvenilir görünmektedir. Klopidogrelin aspirini tolere edemeyen hastalar için alternatif olabilmesi konusunda daha geniş çaplı çalışmalara ihtiyaç olduğu açıktır.

Anahtar Kelimeler:

Aspirin, klopidogrel, gastrointestinal yan etki

The gastrointestinal adverse effects of low dose aspirin compared with clopidogrel

Background/aims: Aside from its gastrointestinal adverse effects, aspirin is the most efficacious antiplatelet agent in clinical use today because of its easy usage, long-term experience and low cost. A related drug, clopidogrel, has been proposed as a substitute. Our aim was to evaluate the gastrointestinal adverse effects of aspirin and clopidogrel usage by means of endoscopy, symptom scoring and following gastrointestinal bleeding. Materials and methods: Fifty patients with coronary artery disease, cerebrovascular disease, diabetes mellitus, congestive heart failure, hypertension or transient ischemic attack (34 F, 16 M, average age: 59±10) were included in the present study. The participants were randomized to receive either aspirin 100 mg/day or clopidogrel 75 mg/day. Results: According to the results of our study, there were no statistical differences in hemorrhagic risk, symptom scores or endoscopic findings in patients who had used low-dose aspirin or clopidogrel (P>0.5). Conclusions: Our results indicate that aspirin and clopidogrel are comparable drugs. Further investigations are needed to evaluate whether clopidogrel may be used instead of aspirin to avoid its gastrointestinal adverse effects.

Keywords:

Aspirin, clopidogrel, gastrointestinal adverse effect,

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