Non-steroidal anti-inflammatory drugs and variceal bleeding: a case-control study.
OBJECTIVE
The aim of this case-control study was to assess the risk of bleeding from esophageal varices associated with aspirin and non-steroidal anti-inflammatory drug consumption.


METHODS
Between January 1992 and May 1994, patients admitted for bleeding from esophageal or gastric lesions related to portal hypertension were matched with a control patient of the same age and sex, who was free of gastrointestinal bleeding. A structured interview was conducted with the cases and controls to determine drug consumption during the 2 weeks preceding admission. Fifty-nine cases and 59 controls were recruited.


CONCLUSIONS
Use of aspirin was more prevalent among the cases than the controls (odds ratio 3.81; 95% confidence interval 1.36-11.64; p = 0.004). This difference remained significant in the subgroups of patients with a first episode of variceal bleeding (odds ratio 3.9; 95% confidence interval 1.2-13.9, p = 0.01), but was not significant in the subgroups of patients with a recurrent episode of variceal bleeding. The use of aspirin was associated with a high risk of a first episode of variceal bleeding, suggesting that patients with portal hypertension should avoid taking these drugs.
de Lédinghen
V
V
Service d'Hepatologie, Centre Hospitalier Universitaire, Poitiers, France.
Mannant
P R
PR
Foucher
J
J
Perault
M C
MC
Barrioz
T
T
Ingrand
P
P
Vandel
B
B
Silvain
C
C
Beauchant
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D016022:Case-Control Studies; D004932:Esophageal and Gastric Varices / Q000209:etiology*; D005069:Evaluation Studies as Topic; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin