Upper gastrointestinal ulcer in Japanese patients taking low-dose aspirin

• Published in: Journal of gastroenterology 2009-02, Vol.44 (2), p.126-131
• Main Authors: Shiotani, Akiko, Sakakibara, Takashi, Yamanaka, Yoshiyuki, Imamura, Hiroshi, Tarumi, Ken-Ichi, Manabe, Noriaki, Kamada, Tomoari, Kusunoki, Hiroaki, Hata, Jiro, Haruma, Ken
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Aged; Aged, 80 and over; Alimentary Tract; Anti-Inflammatory Agents, Non-Steroidal - administration & dosage; anticoagulants; antihypertensive medicine; Aspirin - administration & dosage; Cardiovascular Agents - administration & dosage; Colorectal Surgery; Endoscopy; Female; Gastroenterology; H. pylori; Helicobacter Infections - complications; Helicobacter pylori; Hepatology; Humans; Japan; Male; Medicine; Medicine & Public Health; Middle Aged; Peptic Ulcer - diagnosis; Peptic Ulcer - epidemiology; Polypharmacy; Prospective Studies; proton pump inhibitor; Risk Factors; Surgical Oncology
• ISSN: 0944-1174; 1435-5922
• DOI: 10.1007/s00535-008-2290-6

Background There are few studies on the association of the risks of upper gastrointestinal (GI) ulcer induced by aspirin combined with other medicines. We investigated the association between peptic ulcer and clinical parameters, including Helicobacter pylori infection and combinations of medicines. Methods Patients taking 100 mg aspirin for cardiovascular diseases who were planning to undergo endoscopy were enrolled. Serum H. pylori IgG antibody was measured. Results A total of 305 patients were enrolled, and 38 patients (12.4%) had ulcer lesions. Sex, smoking, drinking, body mass index, endoscopic findings for gastric atrophy (open type), or presence of H. pylori were not significantly associated with ulcer lesions. Cotreatment with anticoagulants [ticlopidine, 34.2% vs. 21.3%; adjusted odds ratio (OR), 3.1; 95% confidence interval (CI), 1.4-7.1; ticlopidine plus warfarin, 13.2% vs. 3.7%; adjusted OR, 4.4; 95% CI, 1.3-15], proton pump inhibitor (PPI 5.3% vs. 34.8%; adjusted OR, 0.10; 95% CI, 0.02-0.43), and antihypertensive medicine were significantly associated with peptic ulcer. Among antihypertensive medicines, AT1 receptor blocker and angiotensin-converting enzyme (ACE) inhibitor tended to be associated with upper GI ulcer. Conclusions PPI was superior to H2-receptor antagonist for prevention of peptic ulcer, and cotreatment with AT1 receptor blocker or ACE inhibitor seemed to reduce peptic ulcer among patients taking low-dose aspirin.