Should Low-Dose Aspirin Be Continued After Lower Gastrointestinal Bleed?

When aspirin-treated patients at high cardiovascular (CV) risk develop gastrointestinal (GI) bleeding, should aspirin be continued or stopped? For upper GI bleeding, Hong Kong researchers addressed this question previously in a small randomized trial in aspirin-treated, high–CV-risk patients who presented with bleeding peptic ulcers (NEJM JW Gen Med Feb 1 2010 and Ann Intern Med 2010; 152:1); during short-term follow-up, benefits of continuing aspirin outweighed risks. Now, the same team has performed a retrospective study to examine this issue in patients with lower GI bleeding.

The researchers identified 295 patients at high CV risk who were hospitalized with nonfatal lower GI bleeding while taking low-dose aspirin. After hospitalization, …