PMID- 21139290
OWN - NLM
STAT- MEDLINE
DCOM- 20111108
LR  - 20221207
IS  - 1349-7235 (Electronic)
IS  - 0918-2918 (Linking)
VI  - 49
IP  - 23
DP  - 2010
TI  - Low-dose aspirin-induced gastroduodenal mucosal injury in Japanese patients with 
      arteriosclerotic disease.
PG  - 2537-45
AB  - 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)) was 5.49 (1.82-16.55), 4.56 (1.93-10.75), 0.12 (0.03-0.42), 0.13 
      (0.04-0.40) and 0.11 (0.04-0.29), respectively. Moreover, patients having two or 
      more of five factors [i.e. advanced age (>/=75), anticoagulants, antiplatelet 
      drugs, NSAIDs and corticosteroids] had a significantly higher prevalence of 
      L-ASA-induced gastroduodenal ulcers [OR (CI): 2.39 (1.002-5.69)]. CONCLUSION: 
      Peptic ulcer history, abdominal symptoms and the summation of risk factors 
      increased the risk for L-ASA-induced gastroduodenal ulcers. H2RAs and PPIs were 
      effective for the prevention of L-ASA-induced gastroduodenal ulcers. The 
      cessation of L-ASA before endoscopy might lead to the underestimation of 
      L-ASA-induced gastroduodenal injury.
FAU - Tamura, Isamu
AU  - Tamura I
AD  - Department of Gastroenterology, Kobe University Graduate School of Medicine.
FAU - Fujita, Tsuyoshi
AU  - Fujita T
FAU - Tsumura, Hidetaka
AU  - Tsumura H
FAU - Morita, Yoshinori
AU  - Morita Y
FAU - Yoshida, Masaru
AU  - Yoshida M
FAU - Toyonaga, Takashi
AU  - Toyonaga T
FAU - Hirano, Seiichi
AU  - Hirano S
FAU - Inokuchi, Hideto
AU  - Inokuchi H
FAU - Kutsumi, Hiromu
AU  - Kutsumi H
FAU - Azuma, Takeshi
AU  - Azuma T
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20101201
PL  - Japan
TA  - Intern Med
JT  - Internal medicine (Tokyo, Japan)
JID - 9204241
RN  - 0 (Histamine H2 Antagonists)
RN  - 0 (Proton Pump Inhibitors)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Arteriosclerosis/*drug therapy/epidemiology
MH  - *Asian People
MH  - Aspirin/*administration & dosage/*adverse effects
MH  - Female
MH  - Histamine H2 Antagonists/therapeutic use
MH  - Humans
MH  - Intestinal Mucosa/*drug effects/pathology
MH  - Male
MH  - Middle Aged
MH  - Peptic Ulcer/*chemically induced/diagnosis/prevention & control
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Young Adult
EDAT- 2010/12/09 06:00
MHDA- 2011/11/09 06:00
CRDT- 2010/12/09 06:00
PHST- 2010/12/09 06:00 [entrez]
PHST- 2010/12/09 06:00 [pubmed]
PHST- 2011/11/09 06:00 [medline]
AID - JST.JSTAGE/internalmedicine/49.3824 [pii]
AID - 10.2169/internalmedicine.49.3824 [doi]
PST - ppublish
SO  - Intern Med. 2010;49(23):2537-45. doi: 10.2169/internalmedicine.49.3824. Epub 2010 
      Dec 1.