Discussion
gastric injury, gastrointestinal injury, small-intestinal injury, GIB
To our knowledge, this study is the first to investigate the rate of gastrointestinal injury progression with different antiplatelet therapies after PCI in patients without high risk of GIB. Following a 6-month DAPT course, 53.1% of patients in this study experienced further gastrointestinal injury progression between 6 and 12 months and 54.6% experienced further small-intestinal injury progression. Aspirin monotherapy had the lowest rate of progressive gastrointestinal injury among the 3 regimens. Clopidogrel alone and DAPT induced more progressive gastrointestinal injury, especially in the subgroup with gastrointestinal injury after the initial 6-month DAPT course. In contrast, the incidence of newly developed gastric or small-intestinal injury between 6 and 12 months did not differ significantly between the 3 antiplatelet regimens in the subgroup of patients without gastrointestinal injury at 6 months.Patients with clinically silent gastric or small-intestinal injury are at increased risk of developing overt GIB.In this study, the rate of progressive gastric injury was substantially lower with aspirin alone than with clopidogrel alone or DAPT, as expected.