PMID- 28576397
OWN - NLM
STAT- MEDLINE
DCOM- 20180621
LR  - 20220330
IS  - 1879-0828 (Electronic)
IS  - 0953-6205 (Linking)
VI  - 44
DP  - 2017 Oct
TI  - The contribution of clinical and pathological predisposing factors to severe 
      gastro-duodenal lesions in patients with long-term low-dose aspirin and proton 
      pump inhibitor therapy.
PG  - 62-66
LID - S0953-6205(17)30215-7 [pii]
LID - 10.1016/j.ejim.2017.05.017 [doi]
AB  - BACKGROUND: Preventive strategies developed to avoid the complications of 
      antiplatelet therapies recommend the evaluation of risk factors for 
      gastrointestinal events and indicated gastroprotective strategies. AIM: We aimed 
      to assess the impact of predisposing factors - histological findings, concomitant 
      drug consumption, comorbidities, symptoms, social habits, Helicobacter pylori 
      infection - on severe gastro-duodenal lesions in patients with low-dose aspirin 
      and concomitant protective therapy with proton pump inhibitors (PPI). METHOD: We 
      enrolled 237 patients with LDA and PPI therapy, referred for upper digestive 
      endoscopy, divided into two groups according to the severity of their endoscopic 
      lesions (172 patients with no or mild endoscopic lesions and 65 patients with 
      severe endoscopic lesions). RESULTS: In the univariate logistic regression model, 
      the factors associated with severe gastro-duodenal lesions were gender (OR=1.87, 
      95% CI: 1.04-3.41), anticoagulants (OR=2.40, 95% CI: 1.26-4.53), gastric atrophy 
      and/or intestinal metaplasia (OR=1.85, 95% CI: 1.04-3.32), congestive heart 
      failure (OR=2.59, 95% CI: 1.16-6.62), anaemia (OR=3.01, 95% CI: 1.67-5.47) and 
      smoking (OR=4.29, 95% CI: 1.57-12.32). In the final model, anticoagulants 
      (p=0.041<0.05) and anaemia (p=0.019<0.05) were risk factors for severe lesions 
      via multivariate regression analysis, while for active/inactive chronic gastritis 
      and smoking a positive dependency with a tendency towards statistical 
      significance (p<0.10) was noticed for severe gastric lesions. CONCLUSIONS: In 
      patients treated with low-dose aspirin and gastroprotective therapy with proton 
      pump inhibitors we have enough evidence to consider co-treatment with 
      anticoagulants and anaemia important predictors for severe endoscopic lesions, 
      while other factors such as inflammation in gastric biopsies, congestive heart 
      failure, co-treatment with clopidogrel and smoking tended to have a positive 
      influence on risk for severe gastro-duodenal lesions.
CI  - Copyright (c) 2017 European Federation of Internal Medicine. Published by Elsevier 
      B.V. All rights reserved.
FAU - Negovan, Anca
AU  - Negovan A
AD  - University of Medicine and Pharmacy, Clinical Science-Internal Medicine, Gheorghe 
      Marinescu 38, Tirgu Mures 540139, Romania.
FAU - Iancu, Mihaela
AU  - Iancu M
AD  - University of Medicine and Pharmacy "Iuliu Hatieganu", Department of Medical 
      Informatics and Biostatistics, Louis Pasteur St, no. 6, 400349 Cluj-Napoca, 
      Romania. Electronic address: miancu@umfcluj.ro.
FAU - Moldovan, Valeriu
AU  - Moldovan V
AD  - University of Medicine and Pharmacy, Morphological Science, Gheorghe Marinescu 
      38, Tirgu Mures 540139, Romania.
FAU - Sarkany, Kinga
AU  - Sarkany K
AD  - Emergency County Hospital, IIIrd Medical Clinic, Gheorghe Marinescu 50, Tirgu 
      Mures 540136, Mures, Romania.
FAU - Bataga, Simona
AU  - Bataga S
AD  - University of Medicine and Pharmacy, Clinical Science-Internal Medicine, Gheorghe 
      Marinescu 38, Tirgu Mures 540139, Romania.
FAU - Mocan, Simona
AU  - Mocan S
AD  - Emergency County Hospital, Pathological Department, Gheorghe Marinescu 50, Tirgu 
      Mures 540136, Mures, Romania.
FAU - Tilea, Ioan
AU  - Tilea I
AD  - University of Medicine and Pharmacy, Clinical Science-Internal Medicine, Gheorghe 
      Marinescu 38, Tirgu Mures 540139, Romania.
FAU - Banescu, Claudia
AU  - Banescu C
AD  - University of Medicine and Pharmacy, Morphological Science, Gheorghe Marinescu 
      38, Tirgu Mures 540139, Romania.
LA  - eng
PT  - Journal Article
DEP - 20170531
PL  - Netherlands
TA  - Eur J Intern Med
JT  - European journal of internal medicine
JID - 9003220
RN  - 0 (Proton Pump Inhibitors)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
CIN - Eur J Intern Med. 2018 Apr;50:e29-e30. PMID: 29113707
CIN - Eur J Intern Med. 2018 Apr;50:e31-e32. PMID: 29203056
MH  - Aged
MH  - Anemia/complications
MH  - Aspirin/*administration & dosage
MH  - Atrophy
MH  - *Causality
MH  - Endoscopy, Gastrointestinal
MH  - Female
MH  - Gastrointestinal Diseases/*drug therapy/*etiology/*pathology
MH  - Helicobacter Infections/complications
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Proton Pump Inhibitors/*administration & dosage
MH  - Risk Factors
MH  - Smoking/adverse effects
OTO - NOTNLM
OT  - Anaemia
OT  - Gastro-duodenal lesion
OT  - Helicobacter pylori
OT  - Inflammatory gastritis
OT  - Low-dose aspirin
OT  - Proton pump inhibitors
OT  - Smoking
EDAT- 2017/06/04 06:00
MHDA- 2018/06/22 06:00
CRDT- 2017/06/04 06:00
PHST- 2016/12/18 00:00 [received]
PHST- 2017/05/16 00:00 [revised]
PHST- 2017/05/17 00:00 [accepted]
PHST- 2017/06/04 06:00 [pubmed]
PHST- 2018/06/22 06:00 [medline]
PHST- 2017/06/04 06:00 [entrez]
AID - S0953-6205(17)30215-7 [pii]
AID - 10.1016/j.ejim.2017.05.017 [doi]
PST - ppublish
SO  - Eur J Intern Med. 2017 Oct;44:62-66. doi: 10.1016/j.ejim.2017.05.017. Epub 2017 
      May 31.