title: Gastric injury caused by low-dose aspirin therapy in consecutive Japanese patients: a prospective study.
abstract: OBJECTIVE
  Low-dose aspirin (<325 mg/day), administered to those with several conditions involving ischemic disorders, can cause upper gastrointestinal (GI) complications. In this prospective study, we aimed to clarify the incidence of aspirin-induced gastric ulcers in consecutive Japanese patients and identify suitable preventive measures.
  
  
  METHODS
  We recruited 125 consecutive adult outpatients who received low-dose aspirin (enteric-coated tablets 100 mg) for >8 weeks. Endoscopy and blood tests were used to evaluate their gastric injury (which was scored using a modified Lanza scale) and anti-Helicobacter pylori antibody titer, respectively.
  
  
  RESULTS
  We found that 39.8% of patients received either no upper GI drug or only mucoprotective drugs, 39.8% received medium-dose histamine H2 blockers, and 20.4% received proton-pump inhibitors (PPIs). Anti-H. pylori antibody titers were positive in 43.7% of patients. The incidence of definitive gastric ulcers in this population was 0.97%. Ordered logistic regression analysis revealed that the odds ratio for the increase in the modified Lanza score was 0.20 for medium-dose histamine H2 blockers and 0.09 for PPIs.
  
  
  CONCLUSIONS
  The incidence of postoperative definitive gastric ulcers in Japanese patients receiving ≤100 mg enteric-coated aspirin was 0.97%. The use of PPIs and histamine H(2) blockers may prevent aspirin-induced gastric injury in such patients.
authors.affiliation: Department of Cardiovascular Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan. sfukuda@hosp.ncgm.go.jp
authors.forename: Shoji
authors.initials: S
authors.lastname: Fukuda
authors.forename: Shigeru
authors.initials: S
authors.lastname: Hosaka
authors.forename: Naomi
authors.initials: N
authors.lastname: Ozawa
authors.forename: Sam
authors.initials: S
authors.lastname: Akita
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Kashima
authors.forename: Sosuke
authors.initials: S
authors.lastname: Kimura
authors.forename: Junichi
authors.initials: J
authors.lastname: Akiyama
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mizoue
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D044466:Asian People; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000601:surgery; D016009:Chi-Square Distribution; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects* / Q000473:pathology; D005773:Gastroscopy; D016480:Helicobacter pylori / Q000276:immunology; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D018570:Risk Assessment; D012307:Risk Factors; D013276:Stomach Ulcer / Q000139:chemically induced* / Q000208:ethnology / Q000473:pathology / Q000517:prevention & control; D013608:Tablets, Enteric-Coated; D013997:Time Factors
chemical_list: D000897:Anti-Ulcer Agents; D000907:Antibodies, Bacterial; D002317:Cardiovascular Agents; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D013608:Tablets, Enteric-Coated; D001241:Aspirin