Peptic Ulcer Bleeding: Interaction between Non-Steroidal Anti-Inflammatory Drugs,Helicobacter pyloriInfection, and the ABO Blood Group System

Abstract

H. pylori infection may add only a little to the important risk of NSAID use in the development of bleeding peptic ulcers.

Systematic Review of the Epidemiology of Complicated Peptic Ulcer Disease: Incidence, Recurrence, Risk Factors and Mortality

“…Three prospective studies reported an association between H. pylori infection and peptic ulcer bleeding [22,23,31]. The greatest increase in risk was found by Santolaria et al [23], who reported a RR of 5.98 (95% CI: 2.9–12.3) in their study of 520 patients in secondary care in Spain.…”

“…The largest increase in risk was found in a prospective study of 96 patients with hemorrhage and 106 control patients with a nonbleeding ulcer in Turkey, which found an OR associated with NSAID use of 33.9 (95% CI: 4.4–263.0) [26]. In a second prospective study of 227 patients with peptic ulcer hemorrhage in the Netherlands, the RR of bleeding associated with NSAID use was 8.4 (95% CI: 6.4–10.9) [22]. …”

“…Most studies examined risk factors for hemorrhage, but two examined risk factors for perforation [18,19], and one included patients with any complication [20]. Prior use of NSAIDs was the most commonly identified risk factor for peptic ulcer hemorrhage (10 studies) [21,22,23,24,25,26,27,28,29,30]. The largest increase in risk was found in a prospective study of 96 patients with hemorrhage and 106 control patients with a nonbleeding ulcer in Turkey, which found an OR associated with NSAID use of 33.9 (95% CI: 4.4–263.0) [26].…”

Relationship between ABO blood group and bleeding complications in orally anticoagulated patients

“…FVII, FVIII and von Willebrand factor levels may be affected by a cold environment prior to centrifugation [8][9][10]. The precentrifugation storage temperature and the duration of exposure to a low temperature prior to centrifugation did not appear to influence the measured levels of prothrombin, FV, FVII, FIX, FXI and FXII in the study of Favaloro [8].…”

“…For instance, Kuyvenhoven et al [9] analysed the interaction between nonsteroidal anti-inflammatory drugs (NSAIDs), Helicobacter pylori infection and ABO blood group in patients with peptic ulcer bleeding but, among the parameters studied, only NSAID use emerged as a strong predictor (relative risk, 8.4) for hemorrhage caused by a peptic ulcer. Ionescu et al…”