title: Effect of aspirin cessation before endoscopy in Japanese patients with low-dose-aspirin-associated gastroduodenal mucosal injury.
abstract: BACKGROUND
  The incidence of upper gastrointestinal injury by low-dose aspirin (LDA) has increased.
  
  
  OBJECTIVE
  We aimed to clarify the risk factors and prevention strategies associated with LDA-induced gastroduodenal ulcer in Japanese patients.
  
  
  METHODS
  A retrospective study involving 284 LDA users who underwent oesophagogastroduodenoscopy between January and December 2010 were included. We investigated the patients' clinical characteristics and endoscopic findings.
  
  
  RESULTS
  Of 284 patients, 29 (10.2%) had gastro and/or duodenal ulcers. Male gender, peptic ulcer history, abdominal symptoms, half-dose proton pump inhibitors (PPIs), complete-dose PPIs, and nonsteroidal anti-inflammatory drugs were significantly associated with LDA-induced gastro and/or duodenal ulcers: odds ratio (95% confidence interval) 3.62 (1.06-12.27), 6.60 (1.84-23.62), 3.06 (1.12-8.40), 0.16 (0.03-0.94), 0.07 (0.01-0.61), and 9.68 (1.64-57.18), respectively. PPI significantly reduced gastric ulcers and/or duodenal ulcers (p = 0.03). The modified Lanza score for gastric mucosal lesion in the LDA cessation group was significantly lower than in the LDA noncessation group (0.53 vs. 1.02; p = 0.008).
  
  
  CONCLUSIONS
  Half-dose PPIs as well as complete-dose PPIs were effective for preventing LDA-induced gastric and/or duodenal ulcers. The cessation of LDA before endoscopy may lead to an underestimation of LDA-induced gastric injury.
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sasaki
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Noguchi
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Sumiharu
authors.initials: S
authors.lastname: Yamaguchi
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Okaniwa
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanabe
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Hisatsugu
authors.initials: H
authors.lastname: Noda
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Yanamoto
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tamura
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kondo
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Masui
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Izawa
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Iida
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Mizuno
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Naotaka
authors.initials: N
authors.lastname: Ogasawara
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Funaki
authors.affiliation: Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Kunio
authors.initials: K
authors.lastname: Kasugai
keywords: Gastric mucosal injury; PPI; gastroduodenal ulcer; low-dose aspirin