{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T13:29:17Z","timestamp":1762176557692},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,1,20]],"date-time":"2012-01-20T00:00:00Z","timestamp":1327017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Low\u2010dose aspirin (ASA) has emerged as one of the most important causes of peptic ulcer bleeding in developed countries. Among the risk factors of ASA\u2010associated ulcer bleeding, <jats:italic>Helicobacter pylori<\/jats:italic> infection is one of the few that is treatable. Recent evidence showed that among patients with a history of ASA\u2010associated ulcer bleeding, the long\u2010term incidence of recurrent bleeding with ASA use is low after eradication of <jats:italic>H.\u2003pylori<\/jats:italic> alone. Thus, test\u2010and\u2010treat <jats:italic>H.\u2003pylori<\/jats:italic> is a potentially useful strategy for ASA users with high ulcer risk. However, the risk of bleeding is further increased by combining other anti\u2010platelet drugs (e.g. clopidogrel) with ASA in acute coronary syndromes and coronary stent placement. There is good evidence that co\u2010therapy with a proton\u2010pump inhibitor (PPI) reduces upper gastrointestinal bleeding with ASA alone or dual anti\u2010platelet therapy. Recently, several meta\u2010analyses of observational studies found that concurrent use of PPI and clopidogrel was associated with increased risk of major adverse cardiovascular events. Overall, the evidence does not suggest a clinically important interaction between PPIs and clopidogrel. However, there is a subset of patients who have reduced conversion of clopidogrel to its active metabolites due to genetic polymorphism of hepatic P\u2010450 (carriers of CYP2C19 loss\u2010of\u2010function alleles). Since PPIs are also metabolized by similar hepatic enzymes, it is uncertain whether patients carrying CY2C19 loss\u2010of\u2010function alleles are susceptible to concomitant PPI use. In the future, management of patients on dual anti\u2010platelet therapy needs to be individualized according to their thrombotic and bleeding risks.<\/jats:p>","DOI":"10.1111\/j.1440-1746.2011.07029.x","type":"journal-article","created":{"date-parts":[[2011,12,6]],"date-time":"2011-12-06T11:46:17Z","timestamp":1323171977000},"page":"195-199","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Anti\u2010platelet therapy and managing ulcer risk"],"prefix":"10.1111","volume":"27","author":[{"given":"Francis K L","family":"Chan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,1,20]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2005.02560.x"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2002.01230.x"},{"key":"e_1_2_10_4_2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.7326\/ACPJC-2007-146-1-013","article-title":"Review: low\u2010dose aspirin causes a small increase in gastrointestinal bleeding","volume":"146","author":"Chan FK","year":"2007","journal-title":"ACP J. 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