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Appropriate treatment for acute coronary syndromes (ACS) involves a combination of antiplatelet, antithrombotic, and anticoagulant therapy. Recent data suggest that this combination increases the risk for upper gastrointestinal bleeding (UGIB) (JW Gastroenterol Jan 4 2008). To further evaluate this risk, investigators retrospectively reviewed the records of all patients at a Hong Kong hospital who received aspirin, clopidogrel, and enoxaparin for ACS or acute myocardial infarction between January 2002 and December 2006.
Of the 666 patients identified, 18 (2.7%) had evidence of acute UGIB within 7 days after discontinuing enoxaparin, and another 35 (5.3%) had occult UGIB (defined as a drop in hemoglobin of ≥2 g/dL in the absence of another bl…