A 78-year-old woman with a CFS of 4 has been taking Clopidogrel 75 mg daily since her ischaemic stroke 2 years ago. She has no other cardiovascular di...

Question

A 78-year-old woman with a CFS of 4 has been taking Clopidogrel 75 mg daily since her ischaemic stroke 2 years ago. She has no other cardiovascular disease and is not in atrial fibrillation. She develops melena and is found to have a haemoglobin of 84 g/L. OGD reveals a gastric ulcer. She is started on high-dose PPI and the ulcer is treated. After recovery, what is the MOST appropriate decision regarding antiplatelet therapy?

Accepted Answer

Continue Clopidogrel with concurrent PPI gastroprotection, as the benefit of secondary stroke prevention outweighs the GI bleeding risk when gastroprotection is provided

Answer

Stop Clopidogrel permanently as she has had a GI bleed

Answer

Switch to Warfarin as it is safer for the GI tract

Answer

Switch to Aspirin as it has fewer GI side effects than Clopidogrel

Answer

Stop all antithrombotic therapy and rely on statin alone

uk-dgm MCQ (SBA): Antiplatelet Continuation After GI Bleed