Association of gastric mucosal injury severity with platelet function and gastric pH during low-dose aspirin treatment.
BACKGROUND
The antiplatelet effects of low-dose aspirin (LDA) vary between individuals. Here, we investigated the relationship between the incidence of LDA-induced mucosal injury, antiplatelet effects of LDA, and intragastric pH.


METHODS
We evaluated gastric injury severity and platelet function using the VerifyNow® System before and after administration of 100 mg aspirin for 7 days to 18 young healthy subjects (study 1). We investigated whether injury was correlated with platelet function and gastric juice pH in 45 patients with cardiovascular disease administered LDA daily (study 2).


RESULTS
In study 1, platelet aggregation was attenuated by LDA to different degrees. Although 55.6% of subjects (10/18) developed gastric injury of modified Lanza score (MLS) ≥ 3, no significant difference in platelet function was detected between the mild (n = 8, MLS: 0-2) and severe injury groups (n = 10, MLS: 3-5). In study 2, the severity of LDA-induced injury was associated with gastric juice pH, but not with antiplatelet effects of LDA.


CONCLUSIONS
In contrast to gastric juice pH, the antiplatelet effect had no correlation with the severity of gastric mucosal injury. Monitoring gastric acidity, rather than platelet function, may be useful for predicting the risk of gastric injury during LDA treatment.
First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Masafumi
M
Nishino
Mitsushige
M
Sugimoto
Takahiro
T
Uotani
Mihoko
M
Yamade
Shu
S
Sahara
Hitomi
H
Ichikawa
Ken
K
Sugimoto
Kazuo
K
Umemura
Hiroshi
H
Watanabe
Hiroaki
H
Miyajima
Takahisa
T
Furuta
D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects* / Q000293:injuries*; D005773:Gastroscopy; D064368:Healthy Volunteers; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D010979:Platelet Function Tests; D013272:Stomach Diseases / Q000139:chemically induced*; D055815:Young Adult
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin