Background: Long-term administration of low-dose aspirin (LDA) is associated with a greater risk of adverse events,\r\nincluding gastroduodenal ulcers. The purpose of this study was to identify the risk factors for and assess the role of\r\nmedication use in the development of peptic ulcer disease in Japanese patients with no history of peptic ulcers.\r\nMethods: Consecutive outpatients receiving LDA (75 mg/day) who underwent esophagogastroduodenoscopy\r\nbetween January and December 2010 were enrolled. Clinical parameters, peptic ulcer history, concomitant drugs,\r\nthe presence of Helicobacter pylori infection, reason for endoscopy, and endoscopic findings were analysed.\r\nResults: Of 226 total patients, 14 (6.2%) were endoscopically diagnosed with peptic ulcer. Age, sex, current\r\nsmoking status, current alcohol consumption, endoscopic gastric mucosal atrophy, and abdominal symptoms\r\nwere not significantly associated with peptic ulcers. Diabetes mellitus was more frequent (42.9% vs. 16.5%; P = 0.024) in\r\npatients with peptic ulcers than in those without peptic ulcers. Using multiple logistic regression analysis, co-treatment\r\nwith anticoagulants or proton pump inhibitors (PPIs) was significantly associated with increased and decreased risk for\r\npeptic ulcer, respectively (odds ratio [OR], 5.88; 95% confidence interval [CI], 1.19 - 28.99; P = 0.03 and OR, 0.13; 95% CI,\r\n0.02 - 0.73; P = 0.02, respectively). Co-treatment with additional antiplatelet agents, H2-receptor antagonists, angiotensin\r\nII Type 1 receptor blockers, angiotensin-converting enzyme inhibitor, 3-hydroxy-3-methylglutaryl-CoA reductase\r\ninhibitor, or nonsteroidal anti-inflammatory drugs was not associated with peptic ulcer development.\r\nConclusion: The use of PPIs reduces the risk of developing gastric or duodenal ulcers in Japanese patients taking\r\nLDA without pre-existing gastroduodenal ulcers. However, this risk is significantly increased in both patients ingesting\r\nanticoagulants and patients with diabetes. These results may help identify patients who require intensive prophylaxis\r\nagainst aspirin-induced peptic ulcers.
Loading....