Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2009
Clopidogrel versus low-dose aspirin as risk factors for epistaxis.
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Rainsbury J W, Molony N C
Аннотация
OBJECTIVES: To quantify the relative risk of epistaxis for patients taking low-dose aspirin or clopidogrel compared to patients taking neither drug.
DESIGN: Case-control study.
SETTING: Primary care.
PARTICIPANTS: 10,241 patients from three GP practices in the West Midlands.
MAIN OUTCOME MEASURES: Epistaxis resulting in presentation to the GP, attendance at Accident & Emergency, or referral to ENT outpatients.
RESULTS: There was a significant difference in the proportion of patients with epistaxis across the three groups (chi(2) = 84.1; 2 degrees of freedom; P < 0.000001). Relative risk of epistaxis was increased in both the aspirin (RR = 9.04; 95% CI = 5.13-15.96) and clopidogrel (RR = 6.40; 95% CI = 2.33-17.56) groups compared to the no drug group. There was no increased risk of epistaxis with aspirin compared to clopidogrel (RR = 1.4; 95% CI = 0.6-3.4).
CONCLUSION: There is an increased risk of troublesome epistaxis in patients taking aspirin or clopidogrel. There is no significant difference in risk of epistaxis between the two drug groups.
DESIGN: Case-control study.
SETTING: Primary care.
PARTICIPANTS: 10,241 patients from three GP practices in the West Midlands.
MAIN OUTCOME MEASURES: Epistaxis resulting in presentation to the GP, attendance at Accident & Emergency, or referral to ENT outpatients.
RESULTS: There was a significant difference in the proportion of patients with epistaxis across the three groups (chi(2) = 84.1; 2 degrees of freedom; P < 0.000001). Relative risk of epistaxis was increased in both the aspirin (RR = 9.04; 95% CI = 5.13-15.96) and clopidogrel (RR = 6.40; 95% CI = 2.33-17.56) groups compared to the no drug group. There was no increased risk of epistaxis with aspirin compared to clopidogrel (RR = 1.4; 95% CI = 0.6-3.4).
CONCLUSION: There is an increased risk of troublesome epistaxis in patients taking aspirin or clopidogrel. There is no significant difference in risk of epistaxis between the two drug groups.