Aspirin and Anticoagulant Drug Combinations Can Cause GI Problems: Study

A new study indicates that some common drugs, when combined to treat heart conditions, can lead to potentially dangerous gastrointestinal (GI) side effects.

Data from a Department of Veteran Affairs database indicated that more than 1,000 heart patients given a combination of aspirin-based drugs suffered upper gastrointestinal tract side effects, according to a report by HealthDay News. Those side effects included perforation and bleeding and required immediate medical attention.

The combinations identified as having GI side effects are anticoagulants and aspirin variations that include anticoagulant-antiplatelet (ACAP), aspirin-antiplatelet (ASAP), aspirin-anticoagulant (ASAC) or TRIP (aspirin-anticoagulant-antiplatelet). The combinations are sometimes referred to as Complex Antithrombotic Therapy when used to treat heart problems.

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The study was authored by Dr. Neena S. Abraham of the Michael E. DeBakey VA Medical Center and Baylor College of Medicine in Houston. It looked at data on 78,084 patients from ages 60 to 99 from the VA’s national pharmacy and administrative database. About 30 percent were prescribed one of the drug cocktails between January 2003 and September 2006.

The study found that 1,061 experienced upper GI problems within a year of starting the drug therapy. The side effects often took the form of bleeding or gastrointestinal perforations that can lead to infection of the abdominal cavity. The upper GI tract includes the stomach, pharynx and esophagus.

The combination with the greatest risk was TRIP. According to the study, the risk of an upper GI side effect quadrupled with the use of the drug combination. Additionally, the youngest patients included in the study, those ages 60 to 69, were at a higher risk than older patients. This group was found to be the ones most likely to be prescribed the TRIP drug combination. Younger patients experiencing heart problems are more likely to have heart disease, hypertension and diabetes.

The results of the study will be presented next week at the Digestive Disease Week 2009 conference in Chicago.

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