Upper gastrointestinal ulcer in Japanese patients taking low-dose aspirin

Shiotani, Akiko; Sugihara, Takashi; Yamanaka, Yoshiaki; Imamura, Hiroshi; Tarumi, Ken-ichi; Manabe, Noriaki; Kamada, Takenobu; Kusunoki, Hiroaki; Hata, Jiro; Haruma, Ken

doi:10.1007/s00535-008-2290-6

Cited by 51 publications

(67 citation statements)

References 42 publications

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“…Recent studies in this respect started with the observation that co-treatments with ARB are correlated with a decreased number of ulcer in patients treated with LDA [15]. Researches demonstrating the protective effect of ARB treatments for stress-induced gastric injury were previously published [16,17].…”

Section: Discussionmentioning

confidence: 99%

AGT A-20C (rs5050) gene polymorphism and ulcer occurrence in patients treated with low-dose aspirin: a case-control study / Polimorfismul AGT A-20C și ulcerele gastro-duodenale la pacienții sub tratament cu aspirină în doze antiagregante: studiu caz-control

Negovan¹,

Voidăzan²,

Pantea³

et al. 2015

Romanian Review of Laboratory Medicine

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Genetic factors may play a role in prediction of gastrointestinal side effects of aspirin, one of the most used drugs worldwide. We aim to determine a possible correlation between AGT A-20C (rs5050) gene polymorphism and gastro-duodenal ulcer in patients taking low-dose aspirin, adjusted for clinical and histological characteristics.Results. We enrolled 211 patients stratified according to 83 AC and 6 CC patients. There were no significant differences regarding demographical and clinical parameters, except for the frequency of ulcers (4%, 8.4% respective 50%, p=0.03), endoscopic bleeding signs (12.3%, 14.5% respective 50%, p=0.0001) and the frequency of gastritis in biopsy (63.9%, 54.2% respective 16.7%, p=0.03) (OR:9.66, p=0.04) than AA group, as well as variant C allele compared with normal A allele (OR: 2.12, p=0.04). On multivariate analysis, variant homozygous CC genotype p=0.02) for ulcer, while H. pylori infection (OR:2.40, p=0.04) de ulcer (OR:9.66, p=0.04) fața de grupul cu genotip AA, iar alela mutantă C s-a corelat cu un număr mai mare de ulcere decât alela normală A (OR: 2.12, p=0.04). Genotipul homozigot mutant CC pentru polimorfismul p=0.02) pentru apariția ulcerelor, în timp ce infecția cu H. pylori (OR:2.40, p=0.04)

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Section: Discussionmentioning

confidence: 99%

AGT A-20C (rs5050) gene polymorphism and ulcer occurrence in patients treated with low-dose aspirin: a case-control study / Polimorfismul AGT A-20C și ulcerele gastro-duodenale la pacienții sub tratament cu aspirină în doze antiagregante: studiu caz-control

Negovan¹,

Voidăzan²,

Pantea³

et al. 2015

Romanian Review of Laboratory Medicine

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“…These factors include a high aspirin dose, history of peptic ulcer or ulcer complication, use of NSAIDs, advanced age, concurrent use of anticoagulants, and the presence of severe disease (10). Some reports have pointed out that concurrent use of antiplatelet drugs is a risk factor (11)(12)(13). In Japanese patients, however, the risk factors for L-ASA-induced gastroduodenal mucosal injury have not been fully investigated.…”

Section: Introductionmentioning

confidence: 96%

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

et al. 2010

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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)

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“…We have previously found no association between H. pylori infection and the presence of peptic ulcer among patients taking LDA. 13 H. pylori and aspirin seem to be independent risk factors for peptic ulcer and bleeding, and the increased risk by H. pylori infection may be smaller among patients taking LDA than among those taking non-aspirin NSAIDs in the Japanese population. 3,13,14 Prevention of upper GI ulcer and bleeding induced by LDA Daily doses of 75 mg of aspirin almost completely inhibit COX-1 within a few days and a dose-response effect in terms of risk and aspirin dose has been reported.…”

Section: Risk Factors For Upper Gi Bleedingmentioning

confidence: 95%

“…13 H. pylori and aspirin seem to be independent risk factors for peptic ulcer and bleeding, and the increased risk by H. pylori infection may be smaller among patients taking LDA than among those taking non-aspirin NSAIDs in the Japanese population. 3,13,14 Prevention of upper GI ulcer and bleeding induced by LDA Daily doses of 75 mg of aspirin almost completely inhibit COX-1 within a few days and a dose-response effect in terms of risk and aspirin dose has been reported. 15 According to the data of metaanalyses indicating that doses > 75-150 mg do not provide additional benefits in terms of prevention of cardiovascular events, more than 150 mg of aspirin for cardiovascular risk reduction should not be prescribed.…”

Section: Risk Factors For Upper Gi Bleedingmentioning

confidence: 95%

Risk and preventive factors of low‐dose aspirin‐induced gastroduodenal injuries: A comprehensive review

Shiotani

Manabe

Kamada

et al. 2012

J of Gastro and Hepatol

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The risk of peptic ulcer complications, particularly bleeding, is increased in association with the use of low-dose aspirin (LDA). Risk factors for upper gastrointestinal (GI) ulcer or bleeding among LDA users include a history of prior GI events, older age, chronic renal failure, combined antithrombotic therapy and nonsteroidal anti-inflammatory drugs (NSAIDs). Helicobacter pylori and aspirin seem to be independent risk factors for peptic ulcer and bleeding. The studies report conflicting findings about the effect of H. pylori infection on NSAID-related ulcers, and proton-pump inhibitors (PPIs) seem to be superior to eradication only to prevent recurrent ulcer bleeding with LDA. Previous studies indicate that hypoacidity related to corpus atrophy, as well as taking PPIs and co-treatment with angiotensin type 1 receptor blockers (ARBs) and statins seem to reduce peptic ulcer among LDA users. In addition, the interleukin-1b (IL-1b)-511 T allele and angiotensinogen (AGT)-20 CC, which work as the high-producer allele of IL-1b and AGT, are significantly associated with ulcer or ulcer bleeding. The SLCO1B1*1b haplotype, which has the highest transport activity, may diminish the preventive effect of statins or ARBs. The data are still lacking and further prospective studies are needed to identify the specific risk or protective factors for upper GI ulcer and its complications associated with LDA.Key words angiotensin type 1 receptor blocker, angiotensinogen, aspirin, interleukin-1b, polymorphism, SLCO1B*1b, statins.

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Upper gastrointestinal ulcer in Japanese patients taking low-dose aspirin

Abstract: 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.

Cited by 51 publications

References 42 publications

AGT A-20C (rs5050) gene polymorphism and ulcer occurrence in patients treated with low-dose aspirin: a case-control study / Polimorfismul AGT A-20C și ulcerele gastro-duodenale la pacienții sub tratament cu aspirină în doze antiagregante: studiu caz-control

AGT A-20C (rs5050) gene polymorphism and ulcer occurrence in patients treated with low-dose aspirin: a case-control study / Polimorfismul AGT A-20C și ulcerele gastro-duodenale la pacienții sub tratament cu aspirină în doze antiagregante: studiu caz-control

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

Risk and preventive factors of low‐dose aspirin‐induced gastroduodenal injuries: A comprehensive review

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