Effect of aspirin cessation before endoscopy in Japanese patients with low-dose-aspirin-associated gastroduodenal mucosal injury
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...
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| Published in: | United European gastroenterology journal Vol. 1; no. 4; pp. 259 - 264 |
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| Main Authors: | , , , , , , , , , , , , , , , , |
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| Language: | English |
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01-08-2013
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| Abstract | 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. |
|---|---|
| AbstractList | 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. The incidence of upper gastrointestinal injury by low-dose aspirin (LDA) has increased. We aimed to clarify the risk factors and prevention strategies associated with LDA-induced gastroduodenal ulcer in Japanese patients. 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. 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). 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. 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. BACKGROUNDThe incidence of upper gastrointestinal injury by low-dose aspirin (LDA) has increased. OBJECTIVEWe aimed to clarify the risk factors and prevention strategies associated with LDA-induced gastroduodenal ulcer in Japanese patients. METHODSA 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. RESULTSOf 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). CONCLUSIONSHalf-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. |
| Author | Mizuno, Mari Tamura, Yasuhiro Funaki, Yasushi Noda, Hisatsugu Masui, Ryuta Yamaguchi, Sumiharu Noguchi, Seiji Tanabe, Atsushi Sasaki, Makoto Kasugai, Kunio Okaniwa, Noriko Kondo, Yoshihiro Ito, Yoshitsugu Izawa, Shinya Iida, Akihito Ogasawara, Naotaka Yanamoto, Kenichiro |
| AuthorAffiliation | Aichi Medical University School of Medicine, Nagakute, Japan |
| AuthorAffiliation_xml | – name: Aichi Medical University School of Medicine, Nagakute, Japan |
| Author_xml | – sequence: 1 givenname: Yoshitsugu surname: Ito fullname: Ito, Yoshitsugu – sequence: 2 givenname: Makoto surname: Sasaki fullname: Sasaki, Makoto email: msasaki@aichi-med-u.ac.jp – sequence: 3 givenname: Seiji surname: Noguchi fullname: Noguchi, Seiji – sequence: 4 givenname: Sumiharu surname: Yamaguchi fullname: Yamaguchi, Sumiharu – sequence: 5 givenname: Noriko surname: Okaniwa fullname: Okaniwa, Noriko – sequence: 6 givenname: Atsushi surname: Tanabe fullname: Tanabe, Atsushi – sequence: 7 givenname: Hisatsugu surname: Noda fullname: Noda, Hisatsugu – sequence: 8 givenname: Kenichiro surname: Yanamoto fullname: Yanamoto, Kenichiro – sequence: 9 givenname: Yasuhiro surname: Tamura fullname: Tamura, Yasuhiro – sequence: 10 givenname: Yoshihiro surname: Kondo fullname: Kondo, Yoshihiro – sequence: 11 givenname: Ryuta surname: Masui fullname: Masui, Ryuta – sequence: 12 givenname: Shinya surname: Izawa fullname: Izawa, Shinya – sequence: 13 givenname: Akihito surname: Iida fullname: Iida, Akihito – sequence: 14 givenname: Mari surname: Mizuno fullname: Mizuno, Mari – sequence: 15 givenname: Naotaka surname: Ogasawara fullname: Ogasawara, Naotaka – sequence: 16 givenname: Yasushi surname: Funaki fullname: Funaki, Yasushi – sequence: 17 givenname: Kunio surname: Kasugai fullname: Kasugai, Kunio |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/24917970$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1002_ps_6185 crossref_primary_10_1097_MD_0000000000001047 crossref_primary_10_1007_s00228_021_03167_0 crossref_primary_10_1159_000484029 crossref_primary_10_12998_wjcc_v7_i20_3168 |
| Cites_doi | 10.1016/S0016-5085(99)70545-7 10.1056/NEJM200103293441304 10.1007/s00535-008-2290-6 10.2169/internalmedicine.49.3824 10.1007/s00228-006-0171-6 10.1007/s00535-008-2206-5 10.1056/NEJM200009213431202 10.1111/j.1572-0241.2005.41833.x 10.1055/s-0028-1098086 10.1056/NEJM199803123381105 10.1093/eurheartj/ehp256 10.1007/s00535-011-0397-7 10.1111/j.1572-0241.2008.01995.x 10.1016/S0140-6736(09)61246-0 10.1053/gast.2001.21907 10.1046/j.0306-5251.2001.01476.x 10.3748/wjg.v16.i15.1896 10.1001/archinte.167.6.562 10.1056/NEJM199803123381104 |
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| Keywords | PPI gastroduodenal ulcer Gastric mucosal injury low-dose aspirin |
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| References_xml | – volume: 46 start-page: 724 year: 2011 end-page: 735 article-title: Lansoprazole for secondary prevention of gastric or duodenal ulcers associated with long-term low-dose aspirin therapy: results of a prospective, multicenter, double-blind, randomized, double-dummy, active-controlled trial publication-title: J Gastroenterol contributor: fullname: Itabashi – volume: 343 start-page: 834 year: 2000 end-page: 839 article-title: Nitrovasodilators, low-dose aspirin, other nonsteroidal antiinflammatory drugs, and the risk of upper gastrointestinal bleeding publication-title: N Engl J Med contributor: fullname: Serrano – volume: 62 start-page: 765 year: 2006 end-page: 772 article-title: Case–control study on the association of upper gastrointestinal bleeding and nonsteroidal anti-inflammatory drugs in Japan publication-title: Eur J Clin Pharmacol contributor: fullname: Ota – volume: 30 start-page: 2226 year: 2009 end-page: 2232 article-title: Gastrointestinal bleeding in high risk survivors of myocardial infarction: the VALIANT Trial publication-title: Eur Heart J contributor: fullname: Pfeffer – volume: 16 start-page: 1896 year: 2010 end-page: 1900 article-title: Gender differences of low-dose aspirin-associated gastroduodenal ulcer in Japanese patients publication-title: World J Gastroenterol contributor: fullname: Imajyo – volume: 43 start-page: 83S year: 1998 end-page: 89S article-title: Rebamipide protects against indomethacin-induced gastric mucosal injury in healthy volunteers in a double-blind, placebo-controlled study publication-title: Dig Dis Sci contributor: fullname: Iinuma – volume: 52 start-page: 563 year: 2001 end-page: 571 article-title: Association between aspirin and upper gastrointestinal complications: systematic review of epidemiologic studies publication-title: Br J Clin Pharmacol contributor: fullname: de Abajo – volume: 49 start-page: 2537 year: 2010 end-page: 2545 article-title: Low-dose aspirin-induced gastroduodenal mucosal injury in Japanese patients with arteriosclerotic disease publication-title: Intern Med contributor: fullname: Tsumura – volume: 374 start-page: 119 year: 2009 end-page: 125 article-title: Famotidine for the prevention of peptic ulcers and oesophagitis in patients taking low-dose aspirin (FAMOUS): a phase III, randomised, double-blind, placebo-controlled trial publication-title: Lancet contributor: fullname: Prasad – volume: 344 start-page: 967 year: 2001 end-page: 973 article-title: Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low-dose aspirin or naproxen publication-title: N Engl J Med contributor: fullname: Suen – volume: 103 start-page: 2465 year: 2008 end-page: 2473 article-title: Efficacy of esomeprazole (20 mg once daily) for reducing the risk of gastroduodenal ulcers associated with continuous use of low-dose aspirin publication-title: Am J Gastroenterol contributor: fullname: Labenz – volume: 43 start-page: 581 year: 2008 end-page: 588 article-title: Low-dose aspirin-induced gastrointestinal diseases: past, present, and future publication-title: J Gastroenterol contributor: fullname: Haruma – volume: 338 start-page: 727 year: 1998 end-page: 734 article-title: Omeprazole compared with misoprostol for ulcers associated with nonsteroidal antiinflammatory drugs. 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Omeprazole versus Misoprostol for NSAID‐induced Ulcer Management (OMNIUM) Study Group publication-title: N Engl J Med – volume: 120 start-page: 594 year: 2001 end-page: 606 article-title: Approaches to nonsteroidal anti‐inflammatory drug use in the high‐risk patient publication-title: Gastroenterology – volume: 338 start-page: 719 year: 1998 end-page: 726 article-title: A comparison of omeprazole with ranitidine for ulcers associated with nonsteroidal antiinflammatory drugs. Acid Suppression Trial: Ranitidine versus Omeprazole for NSAID‐associated Ulcer Treatment (ASTRONAUT) Study Group publication-title: N Engl J Med – volume: 43 start-page: 83S year: 1998 end-page: 89S article-title: Rebamipide protects against indomethacin‐induced gastric mucosal injury in healthy volunteers in a double‐blind, placebo‐controlled study publication-title: Dig Dis Sci – volume: 16 start-page: 1896 year: 2010 end-page: 1900 article-title: Gender differences of low‐dose aspirin‐associated gastroduodenal ulcer in Japanese patients publication-title: World J Gastroenterol – volume: 52 start-page: 563 year: 2001 end-page: 571 article-title: Association between aspirin and upper gastrointestinal complications: systematic review of epidemiologic studies publication-title: Br J Clin Pharmacol – volume: 30 start-page: 2226 year: 2009 end-page: 2232 article-title: Gastrointestinal bleeding in high risk survivors of myocardial infarction: the VALIANT Trial publication-title: Eur Heart J – volume: 46 start-page: 724 year: 2011 end-page: 735 article-title: Lansoprazole for secondary prevention of gastric or duodenal ulcers associated with long‐term low‐dose aspirin therapy: results of a prospective, multicenter, double‐blind, randomized, double‐dummy, active‐controlled trial publication-title: J Gastroenterol – volume: 167 start-page: 562 year: 2007 end-page: 572 article-title: Long‐term aspirin use and mortality in women publication-title: Arch Intern Med – volume: 344 start-page: 967 year: 2001 end-page: 973 article-title: Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low‐dose aspirin or naproxen publication-title: N Engl J Med – volume: 1 start-page: 87 year: 1969 end-page: 97 article-title: An endoscopic recognition of the atrophic border and its significance in chronic gastritis publication-title: Endoscopy – volume: 49 start-page: 2537 year: 2010 end-page: 2545 article-title: Low‐dose 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103 start-page: 2465 year: 2008 end-page: 2473 article-title: Efficacy of esomeprazole (20 mg once daily) for reducing the risk of gastroduodenal ulcers associated with continuous use of low‐dose aspirin publication-title: Am J Gastroenterol – volume: 343 start-page: 834 year: 2000 end-page: 839 article-title: Nitrovasodilators, low‐dose aspirin, other nonsteroidal antiinflammatory drugs, and the risk of upper gastrointestinal bleeding publication-title: N Engl J Med – volume: 117 start-page: 17 year: 1999 end-page: 25 article-title: Effects of very low dose daily, long‐term aspirin therapy on gastric, duodenal, and rectal prostaglandin levels and on mucosal injury in healthy humans publication-title: Gastroenterology – volume: 100 start-page: 1685 year: 2005 end-page: 1693 article-title: A nationwide study of mortality associated with hospital admission due to severe gastrointestinal events and those associated with nonsteroidal antiinflammatory drug use publication-title: Am J 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| Snippet | Background
The incidence of upper gastrointestinal injury by low-dose aspirin (LDA) has increased.
Objective
We aimed to clarify the risk factors and... Background The incidence of upper gastrointestinal injury by low‐dose aspirin (LDA) has increased. Objective We aimed to clarify the risk factors and... The incidence of upper gastrointestinal injury by low-dose aspirin (LDA) has increased. We aimed to clarify the risk factors and prevention strategies... BACKGROUNDThe incidence of upper gastrointestinal injury by low-dose aspirin (LDA) has increased. OBJECTIVEWe aimed to clarify the risk factors and prevention... |
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| StartPage | 259 |
| SubjectTerms | Gastric mucosal injury gastroduodenal ulcer low‐dose aspirin Original PPI |
| Title | Effect of aspirin cessation before endoscopy in Japanese patients with low-dose-aspirin-associated gastroduodenal mucosal injury |
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