{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:49:40Z","timestamp":1774486180746,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:00:00Z","timestamp":1668556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005485","name":"American College of Cardiology Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005485","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Guidelines recommend against aspirin for primary prevention of cardiovascular events in individuals with a history of gastrointestinal bleeding (GIB). It is unknown how often patients on primary prevention aspirin hospitalised with GIB have aspirin discontinued at discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine the rate of aspirin deprescription and explore long\u2010term outcomes in patients taking aspirin for primary prevention of cardiovascular events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated all patients hospitalised at Yale\u2010New Haven Hospital between January 2014 and October 2021 with GIB who were on aspirin for primary prevention. Our primary endpoint was the frequency of aspirin deprescription at discharge. Our secondary endpoints were post\u2010discharge hospitalisations for major adverse cardiovascular events (MACE) or GIB. Time\u2010to\u2010event analysis was performed using Kaplan\u2013Meier curves and the log\u2010rank test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 320 patients with GIB on aspirin for primary prevention: median age was 72 (interquartile range [IQR] 61\u201381) years and 297 (92.8%) were on aspirin 81\u2009mg daily. Only 25 (9.0%) patients surviving their hospitalisation were deprescribed aspirin at discharge. Among 260 patients with follow\u2010up (median 1103\u2009days; IQR 367\u20131670), MACE developed post\u2010discharge in 2\/25 (8.0%) with aspirin deprescription versus 37\/235 (15.7%) with aspirin continuation (log\u2010rank <jats:italic>p<\/jats:italic>\u00a0=\u00a00.28). 0\/25 patients with aspirin deprescription had subsequent hospitalisation for GIB versus 17\/235 (7.2%) who continued aspirin (log\u2010rank <jats:italic>p<\/jats:italic>\u00a0=\u00a00.13).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Aspirin for primary cardiovascular prevention was rarely deprescribed at discharge in patients hospitalised with GIB. Processes designed to ensure appropriate deprescription of aspirin are crucial to improve adherence to guidelines, thereby improving the risk\u2013benefit ratio in patients at high risk of subsequent GIB hospitalisations with minimal increased risk of MACE.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.17278","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T07:08:20Z","timestamp":1668668900000},"page":"94-102","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Deprescription of aspirin for primary prevention is uncommon at discharge in hospitalised patients with gastrointestinal bleeding"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1983-0165","authenticated-orcid":false,"given":"Darrick K.","family":"Li","sequence":"first","affiliation":[{"name":"Section of Digestive Diseases, Department of Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shawn Y.","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle L.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Section of Digestive Diseases, Department of Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth W.","family":"Hung","sequence":"additional","affiliation":[{"name":"Section of Digestive Diseases, Department of Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ritu","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Joint Data Analytics Team, Information Technology Service Yale University  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamil","family":"Alexis","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Department of Medicine Bridgeport Hospital  Bridgeport Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Damianos","sequence":"additional","affiliation":[{"name":"Joint Data Analytics Team, Information Technology Service Yale University  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shreyak","family":"Sharma","sequence":"additional","affiliation":[{"name":"Joint Data Analytics Team, Information Technology Service Yale University  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline","family":"Pires","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Diseases, Department of Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Nanna","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Diseases, Department of Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4296-7901","authenticated-orcid":false,"given":"Loren","family":"Laine","sequence":"additional","affiliation":[{"name":"Section of Digestive Diseases, Department of Medicine Yale School of Medicine  New Haven Connecticut USA"},{"name":"VA Connecticut Healthcare System  West Haven Connecticut 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