title: Upper gastrointestinal ulcer in Japanese patients taking low-dose aspirin.
abstract: BACKGROUND
  There are few studies on the association of the risks of upper gastrointestinal (GI) ulcer induced by aspirin combined with other medicines. We investigated the association between peptic ulcer and clinical parameters, including Helicobacter pylori infection and combinations of medicines.
  
  
  METHODS
  Patients taking 100 mg aspirin for cardiovascular diseases who were planning to undergo endoscopy were enrolled. Serum H. pylori IgG antibody was measured.
  
  
  RESULTS
  A total of 305 patients were enrolled, and 38 patients (12.4%) had ulcer lesions. Sex, smoking, drinking, body mass index, endoscopic findings for gastric atrophy (open type), or presence of H. pylori were not significantly associated with ulcer lesions. Cotreatment with anticoagulants [ticlopidine, 34.2% vs. 21.3%; adjusted odds ratio (OR), 3.1; 95% confidence interval (CI), 1.4-7.1; ticlopidine plus warfarin, 13.2% vs. 3.7%; adjusted OR, 4.4; 95% CI, 1.3-15], proton pump inhibitor (PPI 5.3% vs. 34.8%; adjusted OR, 0.10; 95% CI, 0.02-0.43), and antihypertensive medicine were significantly associated with peptic ulcer. Among antihypertensive medicines, AT1 receptor blocker and angiotensin-converting enzyme (ACE) inhibitor tended to be associated with upper GI ulcer.
  
  
  CONCLUSIONS
  PPI was superior to H2-receptor antagonist for prevention of peptic ulcer, and cotreatment with AT1 receptor blocker or ACE inhibitor seemed to reduce peptic ulcer among patients taking low-dose aspirin.
authors.affiliation: Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Shiotani
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakakibara
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Yamanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imamura
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Tarumi
authors.forename: Noriaki
authors.initials: N
authors.lastname: Manabe
authors.forename: Tomoari
authors.initials: T
authors.lastname: Kamada
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kusunoki
authors.forename: Jiro
authors.initials: J
authors.lastname: Hata
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001241:Aspirin / Q000008:administration & dosage*; D002317:Cardiovascular Agents / Q000008:administration & dosage; D004724:Endoscopy; D005260:Female; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000175:diagnosis / Q000453:epidemiology*; D019338:Polypharmacy; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D002317:Cardiovascular Agents; D001241:Aspirin