BACKGROUND: The incidence of upper gastrointestinal injury by low-dose aspirin (LDA) has increased. OBJECTIVE: We aimed to clarify the risk factors and prevention strategies associated with LDA-induced gastroduodenal ulcer in Japanese patients. METHODS: A retrospective study involving 284 LDA users who underwent oesophagogastroduodenoscopy between January and December 2010 were included. We investigated the patients' clinical characteristics and endoscopic findings. RESULTS: Of 284 patients, 29 (10.2%) had gastro and/or duodenal ulcers. Male gender, peptic ulcer history, abdominal symptoms, half-dose proton pump inhibitors (PPIs), complete-dose PPIs, and nonsteroidal anti-inflammatory drugs were significantly associated with LDA-induced gastro and/or duodenal ulcers: odds ratio (95% confidence interval) 3.62 (1.06-12.27), 6.60 (1.84-23.62), 3.06 (1.12-8.40), 0.16 (0.03-0.94), 0.07 (0.01-0.61), and 9.68 (1.64-57.18), respectively. PPI significantly reduced gastric ulcers and/or duodenal ulcers (p = 0.03). The modified Lanza score for gastric mucosal lesion in the LDA cessation group was significantly lower than in the LDA noncessation group (0.53 vs. 1.02; p = 0.008). CONCLUSIONS: Half-dose PPIs as well as complete-dose PPIs were effective for preventing LDA-induced gastric and/or duodenal ulcers. The cessation of LDA before endoscopy may lead to an underestimation of LDA-induced gastric injury.
BACKGROUND: The incidence of upper gastrointestinal injury by low-dose aspirin (LDA) has increased. OBJECTIVE: We aimed to clarify the risk factors and prevention strategies associated with LDA-induced gastroduodenal ulcer in Japanese patients. METHODS: A retrospective study involving 284 LDA users who underwent oesophagogastroduodenoscopy between January and December 2010 were included. We investigated the patients' clinical characteristics and endoscopic findings. RESULTS: Of 284 patients, 29 (10.2%) had gastro and/or duodenal ulcers. Male gender, peptic ulcer history, abdominal symptoms, half-dose proton pump inhibitors (PPIs), complete-dose PPIs, and nonsteroidal anti-inflammatory drugs were significantly associated with LDA-induced gastro and/or duodenal ulcers: odds ratio (95% confidence interval) 3.62 (1.06-12.27), 6.60 (1.84-23.62), 3.06 (1.12-8.40), 0.16 (0.03-0.94), 0.07 (0.01-0.61), and 9.68 (1.64-57.18), respectively. PPI significantly reduced gastric ulcers and/or duodenal ulcers (p = 0.03). The modified Lanza score for gastric mucosal lesion in the LDA cessation group was significantly lower than in the LDA noncessation group (0.53 vs. 1.02; p = 0.008). CONCLUSIONS: Half-dose PPIs as well as complete-dose PPIs were effective for preventing LDA-induced gastric and/or duodenal ulcers. The cessation of LDA before endoscopy may lead to an underestimation of LDA-induced gastric injury.
Authors: F K Chan; S C Chung; B Y Suen; Y T Lee; W K Leung; V K Leung; J C Wu; J Y Lau; Y Hui; M S Lai; H L Chan; J J Sung Journal: N Engl J Med Date: 2001-03-29 Impact factor: 91.245
Authors: A Lanas; E Bajador; P Serrano; J Fuentes; S Carreño; J Guardia; M Sanz; M Montoro; R Sáinz Journal: N Engl J Med Date: 2000-09-21 Impact factor: 91.245
Authors: Angel Lanas; Maria Angeles Perez-Aisa; Faust Feu; Julio Ponce; Esteban Saperas; Santos Santolaria; Luis Rodrigo; Joaquim Balanzo; Eduardo Bajador; Pedro Almela; Jose M Navarro; Fernando Carballo; Manuel Castro; Enrique Quintero Journal: Am J Gastroenterol Date: 2005-08 Impact factor: 10.864
Authors: N D Yeomans; Z Tulassay; L Juhász; I Rácz; J M Howard; C J van Rensburg; A J Swannell; C J Hawkey Journal: N Engl J Med Date: 1998-03-12 Impact factor: 91.245
Authors: C J Hawkey; J A Karrasch; L Szczepañski; D G Walker; A Barkun; A J Swannell; N D Yeomans Journal: N Engl J Med Date: 1998-03-12 Impact factor: 91.245
Authors: Y Naito; T Yoshikawa; S Iinuma; N Yagi; K Matsuyama; Y Boku; T Fujii; N Yoshida; M Kondo; E Sasaki Journal: Dig Dis Sci Date: 1998-09 Impact factor: 3.199