Effect of aspirin cessation before endoscopy in Japanese patients with low-dose-aspirin-associated gastroduodenal mucosal injury

• Published in: United European gastroenterology journal Vol. 1; no. 4; pp. 259 - 264
• Main Authors: Ito, Yoshitsugu, Sasaki, Makoto, Noguchi, Seiji, Yamaguchi, Sumiharu, Okaniwa, Noriko, Tanabe, Atsushi, Noda, Hisatsugu, Yanamoto, Kenichiro, Tamura, Yasuhiro, Kondo, Yoshihiro, Masui, Ryuta, Izawa, Shinya, Iida, Akihito, Mizuno, Mari, Ogasawara, Naotaka, Funaki, Yasushi, Kasugai, Kunio
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-08-2013
• Subjects: Gastric mucosal injury; gastroduodenal ulcer; low‐dose aspirin; Original; PPI; PPI; gastroduodenal ulcer; Gastric mucosal injury; low-dose aspirin
• ISSN: 2050-6406; 2050-6414
• DOI: 10.1177/2050640613491254

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.