Abstract
Background: The patient with cardiovascular disease and antiplatelet therapy who develops a peptic ulcer bleeding requires a complex approach. We aimed to show the therapeutic strategy for these patients adopted in “Floreasca” Emergency Hospital in accordance with current data in the literature. Methods: We analyzed medical data recorded between January 1 and December 31, 2010 in “Floreasca” Emergency Hospital for patients with peptic ulcer bleeding and antiplatelet therapy. We also assessed the results of recent clinical trials and the current guidelines for the treatment of these patients. Results: Patients with peptic ulcer bleeding and antiplatelet therapy have an increased risk of major adverse cardiac events and a significant increase in risk of 30-day all-cause mortality associated with the withdrawal of antiplatelet agents. Conclusion: Individual assessment of cardiovascular and gastrointestinal risks is indicated for each patient. Early reintroduction of antiplatelet therapy should be considered when vascular risk appears to outweigh the risk of gastrointestinal events (usually within 7 days). In these cases, antiplatelet agents resumption should be associated with effective endoscopic hemostasis, proton pomp inhibitors and eradication of Helicobacter pylori, if that infection is demonstrated.
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