Endoscopic survey of low-dose-aspirin-induced gastroduodenal mucosal injuries in patients with ischemic heart disease.
OBJECTIVE
Low-dose aspirin is effective for the prevention of cardiovascular and cerebrovascular events, but the frequency of gastrointestinal injuries among users of low-dose aspirin in Japan is currently unknown. In the present study endoscopic examination was performed to investigate the frequency of gastroduodenal injuries associated with low-dose aspirin in patients with ischemic heart disease (IHD).


METHODS
Screening upper endoscopic examinations were prospectively performed on 131 patients with IHD who were not receiving antiulcer treatment. Endoscopic findings such as ulcers and flat erosions were assessed as mucosal injuries.


RESULTS
Mucosal injuries were found in 62 of 101 (61.4%) low-dose aspirin users and three of 30 (10%) nonaspirin users. There were significantly more mucosal injuries among low-dose aspirin users than among the non-users (P<0.0001). Gastroduodenal ulcers were found in 19 of 101 (18.8%) low-dose aspirin users compared with one of 30 (3.3%) nonaspirin users. The frequency of mucosal injuries was not associated with the duration of aspirin treatment.


CONCLUSIONS
Endoscopy frequently reveals low-dose aspirin-induced gastroduodenal injuries in patients with IHD.
Nema
Hiroaki
H
Department of Gastroenterology, Hokko Memorial Hospital, Sapporo, 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; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D016022:Case-Control Studies; D004334:Drug Administration Schedule; D004381:Duodenal Ulcer / Q000139:chemically induced* / Q000473:pathology; D004384:Duodenoscopy; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects* / Q000473:pathology; D005773:Gastroscopy; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D011446:Prospective Studies; D013276:Stomach Ulcer / Q000139:chemically induced* / Q000473:pathology
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin