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Drug combinations increase bleeding risks

Heart patients are frequently given 2 to 3 different drugs to prevent life threatening blood clots and a second heart attack or stroke. However, a new study has shown these drug combinations can double to quadruple the risk of stomach or intestinal bleeding.

Clot preventing drugs such as aspirin, warfarin or Coumadin and clopidogrel or Plavix are increasingly being given in combinations to heart patients.

Note: this article is a study review and is not intended to offer medical advice. Heart patients who take drug combinations should discuss this study with their doctor.

The drug combination study

U.S. researchers studied 78,000 patients aged 60 to 99 years who had been given four combinations of clot preventing drugs.

Some received aspirin and an anti platelet drug like Plavix that keeps blood platelets from forming clots. Others took an anti platelet drug and an anticoagulant such as warfarin, which prevents the liver from making clotting factors. Some got aspirin and warfarin. Some took all three.

Of the group of patients studied, 30.4% of the patients took a combination of anti clotting drugs. 1,061 of these had bleeding events within the first year.

The study results …

The researchers found an increased risk of gastrointestinal bleeding within a year from the following drug combinations:

  • An anticoagulant and anti platelet drug combination increased the risk of a bleeding event by 70%.
  • An aspirin and anti platelet combination doubled the risk of a bleeding event.
  • An aspirin and anticoagulant combination tripled the risk of bleeding event.
  • Patients who got all 3 drugs had a four fold increase in the risk of gastrointestinal bleeding.

Lead researcher Dr. Neena Abraham said, “We know they are healthy for the heart at preventing strokes and heart attacks, but what physicians now need to consider is short-term potential risks of GI bleeding versus the potential long-term benefits of being on these protective drugs.”

The research at Baylor College of Medicine in Houston, Texas, was presented at the Digestive Disease Week meeting in Chicago.

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