{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T11:07:45Z","timestamp":1782731265565,"version":"3.54.5"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2011,3,15]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>This study evaluated the risk of upper gastrointestinal bleeding (UGIB) associated with use of low-dose acetylsalicylic acid (ASA) alone and in combination with other gastrotoxic medications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>The Health Improvement Network UK primary care database was used to identify individuals 40 to 84 years of age with a UGIB diagnosis in 2000 to 2007 (n=2049). An age-, sex-, and calendar year-matched control group (n=20 000) was identified from the same source population. The relative risk (RR) of UGIB associated with use of low-dose ASA (75 to 300 mg\/d), clopidogrel, and other commonly coadministered medications was estimated by multivariate logistic regression. The risk of UGIB was increased in current users of low-dose ASA (RR, 1.80; 95% confidence interval [CI], 1.59 to 2.03) or clopidogrel (RR, 1.67; 95% CI, 1.24 to 2.24) compared with nonusers. Compared with low-dose ASA monotherapy, the risk of UGIB was significantly increased when low-dose ASA was coadministered with clopidogrel (RR, 2.08; 95% CI, 1.34 to 3.21), oral anticoagulants (RR, 2.00; 95% CI, 1.15 to 3.45), low-\/medium-dose nonsteroidal antiinflammatory drugs (RR, 2.63; 95% CI, 1.93 to 3.60), high-dose nonsteroidal antiinflammatory drugs (RR, 2.66; 95% CI, 1.88 to 3.76), or high-dose oral corticosteroids (RR, 4.43; 95% CI, 2.10 to 9.34); this was not apparent with coadministration of statins (RR, 0.99; 95% CI, 0.81 to 1.21) or low-dose oral corticosteroids (RR, 1.01; 95% CI, 0.58 to 1.77).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Use of low-dose ASA is associated with an almost 2-fold increase in the risk of UGIB compared with nonuse. This risk is increased further in individuals taking low-dose ASA along with clopidogrel, oral anticoagulants, nonsteroidal antiinflammatory drugs, or high-dose oral corticosteroids.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.110.973008","type":"journal-article","created":{"date-parts":[[2011,3,1]],"date-time":"2011-03-01T21:11:39Z","timestamp":1299013899000},"page":"1108-1115","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":161,"title":["Risk of Upper Gastrointestinal Bleeding With Low-Dose Acetylsalicylic Acid Alone and in Combination With Clopidogrel and Other Medications"],"prefix":"10.1161","volume":"123","author":[{"given":"Luis A.","family":"Garc\u00eda Rodr\u00edguez","sequence":"first","affiliation":[{"name":"From the Spanish Centre for Pharmacoepidemiological Research, Madrid, Spain (L.A.G.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (K.J.L., S.H.-D.); and AstraZeneca R&amp;D, M\u00f6lndal, and Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden (S.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kueiyu Joshua","family":"Lin","sequence":"additional","affiliation":[{"name":"From the Spanish Centre for Pharmacoepidemiological Research, Madrid, Spain (L.A.G.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (K.J.L., S.H.-D.); and AstraZeneca R&amp;D, M\u00f6lndal, and Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden (S.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Hern\u00e1ndez-D\u00edaz","sequence":"additional","affiliation":[{"name":"From the Spanish Centre for Pharmacoepidemiological Research, Madrid, Spain (L.A.G.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (K.J.L., S.H.-D.); and AstraZeneca R&amp;D, M\u00f6lndal, and Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden (S.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saga","family":"Johansson","sequence":"additional","affiliation":[{"name":"From the Spanish Centre for Pharmacoepidemiological Research, Madrid, Spain (L.A.G.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (K.J.L., S.H.-D.); and AstraZeneca R&amp;D, M\u00f6lndal, and Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden (S.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-0685"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010746"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16721-4"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.181940"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(01)00941-X"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v11.i9.1365"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.12.007"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.14.2093"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.070186"},{"key":"e_1_3_4_11_2","first-page":"75","article-title":"A language of health in action: Read Codes, classifications and groupings","volume":"996","author":"Stuart-Buttle CD","unstructured":"Stuart-Buttle CD, Read JD, Sanderson HF, Sutton YM. 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