Investigation of gastric and duodenal mucosal defects caused by low-dose aspirin in patients with ischemic heart disease.
BACKGROUND
Low-dose aspirin is used for secondary prevention of ischemic heart disease and ischemic cerebrovascular disease. Currently, the frequency of gastrointestinal disorder among users of low-dose aspirin is unknown.


OBJECTIVE
To investigate through endoscopic examination the frequency of gastroduodenal disorder associated with buffered and enteric-coated aspirin (ECA).


METHODS
Screening upper endoscopic examinations were prospectively performed on 236 patients with ischemic heart disease. Endoscopic findings including ulcers and flat erosions were assessed as mucosal defects.


RESULTS
Mucosal defects were found in 92 of 190 (48.4%) users of low-dose aspirin and 6 of 46 (13.0%) nonusers. There were significantly more mucosal defects among users of low-dose aspirin than among those using no aspirin (P<0.0001). Mucosal defects were found in 54 of 98 (60.7%) users of buffered aspirin (BA), whereas 38 of 101 (37.6%) users of ECA had mucosal defects. Users of ECA had significantly fewer erosions than did those of BA (P=0.0015). The frequency of ulcer is similar between BA users and ECA users.


CONCLUSIONS
As endoscopy frequently reveals gastroduodenal disorder among low-dose aspirin users, both administration of BA and of enteric-coated aspirin warrant concern for gastroduodenal ulcer.
Nema
Hiroaki
H
Department of Gastroenterology, Hokko Memorial Hospital, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
Kato
Mototsugu
M
Katsurada
Takehiko
T
Nozaki
Youichi
Y
Yotsukura
Akihiko
A
Yoshida
Izumi
I
Sato
Katsuhiko
K
Kawai
Yuko
Y
Takagi
Yasushi
Y
Okusa
Takanori
T
Takiguchi
Shunichi
S
Sakurai
Masayuki
M
Asaka
Masahiro
M
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D002021:Buffers; D004334:Drug Administration Schedule; D004386:Duodenum / Q000187:drug effects / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects / Q000473:pathology; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000473:pathology; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects / Q000473:pathology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy*; D013608:Tablets, Enteric-Coated
D000894:Anti-Inflammatory Agents, Non-Steroidal; D002021:Buffers; D013608:Tablets, Enteric-Coated; D001241:Aspirin