[Epidemiology of digestive complications associated with use of low-dose aspirin].
Low-dose aspirin (< 330 mg/d) is recommended for the prevention of myocardial infarction or ischemic stroke. Six to 12% of the general population is exposed to low-dose aspirin. The most frequently studied digestive complications are bleeding peptic ulcers, whose risk is increased twofold by low-dose aspirin treatment, and non-complicated peptic ulcers. History of bleeding or non-complicated peptic ulcer, alcohol intake, concomitant treatment with NSAID or calcic inhibitors are demonstrated risk factors of bleeding ulcer associated with low-dose aspirin. The role of enteric coating, of low-dose aspirin dose, of delay since low-dose aspirin treatment onset, and of Helicobacter pylori infection, remains controversial. Antisecretory drugs (H2 inhibitors, proton pump inhibitors), and nitroglycerin are associated with a decreased risk of bleeding ulcer. The protective effect of COX-2 inhibitors on the risk of bleeding ulcer is suppressed by concomitant treatment with low-dose aspirin. The risk of no- complicated peptic ulcer was increased by low-dose aspirin intake by a factor 2.9 in one study. Low-dose aspirin dose, infection by Helicobacter pylori, NSAID intake, and absence of enteric coating, are possible risk factors for non-complicated peptic ulcer. No association was retrieved with alcohol intake and peptic ulcer history.
Czernichow
Pierre
P
Réseau de Recherche sur le Système de Soins, Université de Rouen, Département d'Epidémiologie et de Santé Publique, CHU, Hôpitaux de Rouen. pierre.czernichow@chu-rouen.fr
Merle
Véronique
V
D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects*; D005767:Gastrointestinal Diseases / Q000139:chemically induced* / Q000453:epidemiology* / Q000209:etiology; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D012307:Risk Factors
D001241:Aspirin
Epidémiologie des complications digestives liées à l'aspirine à faible dose.