Long-term Plavix and Aspirin Use Increase Gastrointestinal Injury Risks: Study

New research suggests that individuals who take Plavix long-term after a heart stent may face a greater risk of experiencing significant stomach problems, compared to those who use aspirin alone.

In findings published this month in the medical journal JAMA Network Open, Chinese researchers warn about the potential gastrointestinal injury risks from continuous Plavix use, including dual platelet therapy that combines Plavix and aspirin.

Plavix (clopidogrel) is an antiplatelet medication that helps to reduce dangerous blood clots among patients who suffer from heart disease and are at risk of heart attack and other heart conditions. However, side effects of Plavix have been linked to an increased risk of bleeding, and there have been questions about the benefits provided by the drug for some patients, when compared to its potential health risks.

Plavix Gastrointestinal Injury Risks

In this new study, researchers from China conducted a secondary analysis of a double-masked randomized clinical trial including nearly 400 participants in the Optimal Antiplatelet Therapy for Prevention of Gastrointestinal Injury Evaluated by ANKON Magnetically Controlled Capsule Endoscopy (OPT-PEACE).

The study was conducted at 28 centers in China from 2017 to 2019. Patients with stable coronary artery disease or acute coronary syndromes underwent percutaneous coronary intervention (PCI), commonly referred to as angioplasty. It is a procedure where doctors place a stent in the heart to open blocked blood vessels due to heart disease.

Patients underwent magnetically controlled capsule endoscopy (MCE) before the PCI procedure, and again after 6 months of therapy, including either single drug or combination treatment. They were randomized into three groups to receive 100 mg of aspirin plus a matching placebo, 75 mg of Plavix plus a matching placebo, or dual therapy, where they received both 100 mg of aspirin and 75 mg of Plavix.

According to the findings, patients taking only Plavix or taking both aspirin and Plavix faced an increased risk of suffering gastric problems or injury to the small intestines. There was a lower rate of intestinal injury among patients who only took aspirin.

Researchers determined that 49% of users who were given Plavix alone suffered gastrointestinal injuries, compared to 53% among those who took both drugs, and only 37% of those who took aspirin alone. They concluded there was no statistically significant difference between injury rates among Plavix users and those who took combination antiplatelet therapy.

“Clopidogrel was at least as likely as aspirin to induce gastrointestinal injury progression,” the researchers concluded. “Future research is warranted to determine what impact the findings from MCEs would have on decision-making of antiplatelet therapy.”