Major gastrointestinal bleeding with aspirin in elderly patients
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Major gastrointestinal bleeding with aspirin in elderly patients In patients aged ≥70 years, aspirin is associated with an increased risk of major gastrointestinal (GI) bleeding, according to study results reported in the BMJ, although "the 5-year absolute risk of serious bleeding is modest in younger, well individuals". The ASPREE study* randomised community-dwelling patients to receive enteric-coated aspirin 100mg (n=9525) or placebo (n=9589). The primary endpoint was disability-free survival, but bleeding endpoints were a prespecified trial outcome. Median patient age was 74 years; 44% of patients were men, and 25% of patients were using proton pump inhibitors at baseline. During a median 4.7 years of follow-up, there were 162 major GI bleeding events in aspirin recipients compared with 102 events in placebo recipients (hazard ratio [HR] 1.61; 95% CI 1.26, 2.08; p=0.002). Two fatal bleeds occurred, both in placebo recipients. Upper GI bleeding occurred in 89 vs 48 patients (HR 1.87; 1.32, 2.66; p
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