Low-Dose Aspirin-Induced Gastroduodenal Mucosal Injury in Japanese Patients with Arteriosclerotic Disease

Abstract

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)

The effect of low dose aspirin intake on gastro-duodenal mucosa, and protective effects of GSH-vitamin C-E

“…Nevertheless human and animal studies have indicated that use of L-ASA causes to mucosal damages in the gastrointestinal system, which might lead to oxidative stress, gastro-duodenal erosion, ulceration, and bleeding [6][7][8][13][14][15][16]. In the present study, we observed histologically gastric and duodenal mucosal injuries induced by use of L-ASA daily for 40 days in agreement with previous reports [13,16].…”

Should patients prescribed long-term low-dose aspirin receive proton pump inhibitors? A systematic review and meta-analysis

“…After screening the titles, abstracts and full text, 13 studies were considered eligible for complete data extraction. Of these, four cohort studies reported on the effect on peptic ulcer, five studies [two cohort and three case–control studies ] on GI bleeding, three studies [two RCTs and one cohort study ] on both GI bleeding and peptic ulcer, and one cohort study on both GI bleeding and CV events. Among nine studies that reported on GI bleeding, six studies indicated the outcomes as upper GI bleeding (UGIB) while the others did not specify the location of the bleeding.…”

“…Two RCTs and five cohort studies reported on the effect on peptic ulcer. Only two of the five cohort studies adjusted the effect estimates for potential confounding. A total number of 5407 patients (2608 patients on PPIs) were included in the analysis.…”

The Assessment of Risk for Gastrointestinal Injury with Anticoagulant and Antiplatelet Drugs: The Possible Beneficial Effect of Eicosapentaenoic Acid for the Risk of Gastrointestinal Injury

“…3,4) Reducing the risk of gastrointestinal injury (e.g., gastrointestinal ulcers and gastrointestinal bleeding) is also an important clinical issue from the viewpoint of facilitating continued treatment with antithrombotic drugs. With these points borne in mind, it is essential to prevent and treat thrombotic cardiovascular and cerebrovascular injuries and to select appropriate antithrombotic drugs.…”

“…With these points borne in mind, it is essential to prevent and treat thrombotic cardiovascular and cerebrovascular injuries and to select appropriate antithrombotic drugs. [2][3][4][5][6][7] However, there are many unresolved questions about the risk of gastrointestinal injury arising from antithrombotic drugs other than low-dose aspirin and the effects of drugs used for the prevention of such injury. Therefore, we carried out a pharmacological study in patients receiving antithrombotic drugs in order to identify the risk factors of gastrointestinal injury associated with antithrombotic drug therapy.…”