Department of Gastroenterology, Zhongshan Hospital Fudan University, Shanghai 200032, China.
World J Gastroenterol. 2011 Sep 21;17(35):4048-51. doi: 10.3748/wjg.v17.i35.4048.
Dual antiplatelet therapy consisting of low-dose aspirin (LDA) and other antiplatelet medications is recommended in patients with coronary heart disease, but it may increase the risk of esophageal lesion and bleeding. We describe a case of esophageal mucosal lesion that was difficult to distinguish from malignancy in a patient with a history of ingesting LDA and prasugrel after implantation of a drug-eluting stent. Multiple auxiliary examinations were performed to make a definite diagnosis. The patient recovered completely after concomitant acid-suppressive therapy. Based on these findings, we strongly argue for the evaluation of the risk of gastrointestinal mucosal injury and hemorrhage if LDA therapy is required, and we stress the paramount importance of using drug combinations in individual patients.
双联抗血小板治疗包括小剂量阿司匹林(LDA)和其他抗血小板药物,适用于冠心病患者,但可能会增加食管损伤和出血的风险。我们描述了一例在植入药物洗脱支架后服用 LDA 和普拉格雷的患者中,出现难以与恶性肿瘤相鉴别的食管黏膜病变的病例。进行了多项辅助检查以明确诊断。患者在联合抑酸治疗后完全康复。基于这些发现,如果需要 LDA 治疗,我们强烈建议评估胃肠道黏膜损伤和出血的风险,并强调在个体患者中使用药物组合的至关重要性。