Doctors' Groups Collaborate on Care for Heart Patients

THURSDAY, Oct. 9 (HealthDay News) -- Three leading medical associations have created guidelines to help heart disease patients cut their risk of ulcers and gastrointestinal bleeding from the condition's most common treatments -- antiplatelets and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin.

The American College of Cardiology, the American College of Gastroenterology and the American Heart Association guidelines call on doctors to better assess the patient's risk factors before treatment starts. These include considering:

age,
previous history of ulcers or bleeding,
presence of H. pylori (a common bacteria that contributes to the development of stomach ulcers), and,
acid reflux symptoms.

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Doctors are also advised to review the patient's use of other NSAIDs, anticoagulants and/or corticosteroids.

Having several of these risk factors greatly increases the person's chance of gastrointestinal bleeding, a major and potentially life-threatening complication.

"These recommendations represent the collective expertise of leading cardiologists and gastroenterologists, as well as an extensive review of the literature, and provide specialists with practical measures to manage competing risks and help improve patient safety," Dr. Deepak L. Bhatt, document co-chair and chief of cardiology at the VA Boston Healthcare System, said in a news release.

Antiplatelets, which reduce the blood's ability to clot, are key to preventing a cardiovascular event in people with atherosclerotic disease. The treatment is usually prescribed with daily low-dose aspirin, a NSAID.

NSAIDs, one of the most widely used classes of drugs in the United States, help reduce fever, pain and inflammation. These drugs -- which include aspirin, ibuprofen, ketoprofen and naproxen -- are often used to treat other common conditions, including arthritis, inflammation and related musculoskeletal pain.

People on low-dose aspirin plus NSAIDs have a two- to fourfold increased risk of gastrointestinal bleeding compared with those not taking these medications, the specialists said.