Low-Dose Aspirin-Induced Gastroduodenal Mucosal Injury in Japanese Patients with Arteriosclerotic Disease
| Autor: | Yoshinori Morita, Tsuyoshi Fujita, Hidetaka Tsumura, Masaru Yoshida, Isamu Tamura, Takeshi Azuma, Hideto Inokuchi, Seiichi Hirano, Takashi Toyonaga, Hiromu Kutsumi |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Peptic Ulcer medicine.medical_specialty Arteriosclerosis medicine.drug_class Proton-pump inhibitor Disease Gastroenterology Young Adult Asian People Risk Factors Internal medicine Internal Medicine Humans Medicine Intestinal Mucosa Young adult Aged Retrospective Studies Aged 80 and over Aspirin medicine.diagnostic_test business.industry Proton Pump Inhibitors Retrospective cohort study General Medicine Odds ratio Middle Aged digestive system diseases Endoscopy Histamine H2 Antagonists Concomitant Female business medicine.drug |
| Zdroj: | Internal Medicine. 49:2537-2545 |
| ISSN: | 1349-7235 0918-2918 |
| DOI: | 10.2169/internalmedicine.49.3824 |
| Popis: | Background We aimed to elucidate the risk factors and preventive factors associated with chronic low-dose aspirin (L-ASA)-induced gastroduodenal mucosal injury in Japanese patients with arteriosclerotic disease. Methods This retrospective observational study included 400 L-ASA users who underwent upper gastrointestinal endoscopy. We investigated patients' clinical characteristics, including age, peptic ulcer history, concomitant drugs [i.e. gastric agents, antiplatelet drugs, anticoagulants, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids], abdominal symptoms, endoscopic findings, and interruption of L-ASA before endoscopy. The severity of gastroduodenal mucosal lesions was evaluated using the modified LANZA score (MLS). Results Of 400 patients, 249 (62%) and 41 (10%) had gastroduodenal mucosal lesions (MLS ≥1) and gastroduodenal ulcers, respectively. Peptic ulcer history, abdominal symptoms, proton pump inhibitor (PPI), histamine type 2-receptor antagonists (H2RA), and the cessation of L-ASA before endoscopy were significantly associated with L-ASA-induced gastroduodenal ulcers; the odds ratio (OR) (confidence interval (CI)) was 5.49 (1.82-16.55), 4.56 (1.93-10.75), 0.12 (0.03-0.42), 0.13 (0.04-0.40) and 0.11 (0.04-0.29), respectively. Moreover, patients having two or more of five factors [i.e. advanced age (≥75), anticoagulants, antiplatelet drugs, NSAIDs and corticosteroids] had a significantly higher prevalence of L-ASA-induced gastroduodenal ulcers [OR (CI): 2.39 (1.002-5.69)]. Conclusion Peptic ulcer history, abdominal symptoms and the summation of risk factors increased the risk for L-ASA-induced gastroduodenal ulcers. H2RAs and PPIs were effective for the prevention of L-ASA-induced gastroduodenal ulcers. The cessation of L-ASA before endoscopy might lead to the underestimation of L-ASA-induced gastroduodenal injury. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|