<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2184-0628</journal-id>
<journal-title><![CDATA[Gazeta Médica]]></journal-title>
<abbrev-journal-title><![CDATA[Gaz Med]]></abbrev-journal-title>
<issn>2184-0628</issn>
<publisher>
<publisher-name><![CDATA[Círculo Médico]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2184-06282022000100040</article-id>
<article-id pub-id-type="doi">10.29315/gm.v1i1.463</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Aspirina, Clopidogrel e Hemorragia Gastrointestinal: Qual a Evidência?]]></article-title>
<article-title xml:lang="en"><![CDATA[Aspirin, Clopidogrel and Gastrointestinal Hemorrhage: What is the Evidence?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alves]]></surname>
<given-names><![CDATA[Eduarda A.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lamas]]></surname>
<given-names><![CDATA[Joana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rocha-Cruz]]></surname>
<given-names><![CDATA[Mariana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,ARS Norte ACES Grande Porto VIII- Espinho/Gaia USF São Miguel]]></institution>
<addr-line><![CDATA[Gaia ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>03</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>03</month>
<year>2022</year>
</pub-date>
<volume>9</volume>
<numero>1</numero>
<fpage>40</fpage>
<lpage>48</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2184-06282022000100040&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2184-06282022000100040&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2184-06282022000100040&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  O ácido acetilsalicílico (AAS), vulgarmente designado por aspirina, é sobejamente utilizado na prevenção secundária de eventos cardiovasculares, assim como o clopidogrel, outro antiagregante plaquetário.É conhecida a associação do AAS ao aumento do risco de complicações gastrointestinais (GI). No entanto, existe alguma evidência científica que sugere uma possível diminuição deste risco com clopidogrel comparativamente com o uso de AAS. Assim, é comum a substituição do AAS pelo clopidogrel em situações de hemorragia. O nosso objetivo foi avaliar a eventual superioridade do clopidogrel na redução do risco hemorrágico GI em doentes a fazer AAS ou clopidogrel em prevenção cardiovascular secundária.  Métodos:  Foi realizada uma pesquisa bibliográfica de artigos publicados entre janeiro de 2000 e agosto de 2020, nas línguas portuguesa e inglesa e indexadas na PubMed, Cochrane, DARE, National Guideline Clearinghouse, Canadian Medical Association Practice Guidelines Infobase e Evidence Based Medicine Online. Os termos MeSH utilizados foram &#8216;clopidogrel&#8217;, &#8216;aspirin&#8217; e &#8216;gastrointestinal hemorrhage&#8217;. A atribuição dos níveis de evidência e forças de recomendação baseou-se na escala Strength of Recommendation Taxonomy (SORT).  Resultados:  A pesquisa inicial encontrou 278 artigos, dos quais foram incluídos na revisão dez: uma revisão sistemática, quatro ensaios clínicos randomizados, três estudos coortes retrospetivos, um estudo coorte prospetivo e um estudo caso-controlo prospetivo.  Conclusão:  Os estudos com maior nível de evidência apontam para a inexistência de superioridade do clopidogrel em relação ao AAS no que concerne a complicações GI (SORT B). Outros sugerem mesmo que a utilização de AAS associada a inibidores da bomba de protões (IBP) reduz este risco comparativamente ao clopidogrel isolado.Na ausência de consenso entre os diversos estudos, sugere-se a realização de novos estudos, nomeadamente ensaios clínicos randomizados, dirigidos especificamente para esta temática.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: The acetylsalicylic acid (ASA), frequently designated as aspirin, is widely used in the secondary prevention of cardiovascular events. Clopidogrel is another platelet antiaggregant used with the same purpose. It is well known the association between ASA and an increased risk of gastrointestinal (GI) complications. On the other hand, there is some evidence that suggests a reduction of this risk using clopidogrel, in comparison to ASA. As a result, it is common the substitution of ASA for clopidogrel in bleeding related situations. Our aim was to evaluate if clopidogrel is superior in the reduction of GI bleeding risk in patients with secondary cardiovascular prevention comparing with ASA.  Methods:  A research was carried out of all the articles published between January of 2000 and August of 2020, in English and Portuguese language and indexed in PubMed, Cochrane, DARE, National Guideline Clearinghouse, Canadian Medical Association Practic Guidelines Infobase and Evidence Based Medicine Online. The MeSH terms used were &#8220;Clopidogrel&#8221;, &#8220;Aspirin&#8221; and &#8220;Gastrointestinal hemorrhage&#8221;. The levels of evidence and strength of recommendation attributed were based in the Strength of Recommendation Taxonomy (SORT).  Results: Initial research found 278 articles. Ten were included in this review: one systematic review, four randomized clinical studies, three cohort retrospective studies, one cohort prospective study and one prospective case-control study.  Conclusion: Studies with higher quality of evidence point to the non-superiority of clopidogrel in comparison with ASA about the risk of GI complications (SORT B). Other studies suggest that the use of ASA associated with proton-pump inhibitors reduces the risk in comparison to clopidogrel alone. Since there is no consensus between different studies, we suggest that new ones should be carried out, targeting specifically this topic, ideally randomized clinical trials.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Aspirina]]></kwd>
<kwd lng="pt"><![CDATA[Clopidogrel]]></kwd>
<kwd lng="pt"><![CDATA[Hemorragia Gastrointestinal]]></kwd>
<kwd lng="en"><![CDATA[Aspirin]]></kwd>
<kwd lng="en"><![CDATA[Clopidogrel]]></kwd>
<kwd lng="en"><![CDATA[Gastrointestinal Hemorrhage]]></kwd>
</kwd-group>
</article-meta>
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