Gastrointestinal endoscopy · 2014
Risk factors for small-bowel mucosal breaks in chronic low-dose aspirin users: data from a prospective multicenter capsule endoscopy registry.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Endo Hiroki, Sakai Eiji, Taniguchi Leo, Kessoku Takaomi, Komiya Yasuhiko, Ezuka Akiko, Kawamura Harunobu, Taguri Masataka, Higurashi Takuma, Ohkubo Hidenori, Yamada Eiji, Takahashi Hirokazu, Inamori Masahiko, Maeda Shin, Sakaguchi Takashi, Hata Yasuo, Nagase Hajime, Nakajima Atsushi
Аннотация
BACKGROUND: To develop appropriate management strategies for patients who take low-dose aspirin, it is important to identify the risk factors for GI injury. However, few studies have described the risk factors for small-bowel injury in these patients.
OBJECTIVE: To investigate factors influencing the risk of small-bowel mucosal breaks in individuals taking continuous low-dose aspirin.
DESIGN: Capsule endoscopy data were collected prospectively from 5 institutions.
SETTING: Yokohama City University Hospital and 4 other hospitals.
PATIENTS: A total of 205 patients receiving treatment with low-dose aspirin for over 3 months.
INTERVENTIONS: Colonoscopic and upper GI endoscopy had been performed in all of the patients before the capsule endoscope evaluation.
MAIN OUTCOME MEASUREMENTS: Risk factors for small-bowel mucosal breaks.
RESULTS: Of the 198 patients (141 male; mean age 71.9 years) included in the final analysis, 114 (57.6%) had at least 1 mucosal break. Multivariate analysis identified protein pump inhibitor (PPI) use (OR 2.04; 95% confidence interval [CI], 1.05-3.97) and use of enteric-coated aspirin (OR 4.05; 95% CI, 1.49-11.0) as independent risk factors for the presence of mucosal breaks.
LIMITATIONS: Cross-sectional study.
CONCLUSION: PPI use appears to increase the risk of small-bowel injury in patients who take continuous low-dose aspirin. Clinicians should be aware of this effect of PPIs; new strategies are needed to treat aspirin-induced gastroenteropathy.
OBJECTIVE: To investigate factors influencing the risk of small-bowel mucosal breaks in individuals taking continuous low-dose aspirin.
DESIGN: Capsule endoscopy data were collected prospectively from 5 institutions.
SETTING: Yokohama City University Hospital and 4 other hospitals.
PATIENTS: A total of 205 patients receiving treatment with low-dose aspirin for over 3 months.
INTERVENTIONS: Colonoscopic and upper GI endoscopy had been performed in all of the patients before the capsule endoscope evaluation.
MAIN OUTCOME MEASUREMENTS: Risk factors for small-bowel mucosal breaks.
RESULTS: Of the 198 patients (141 male; mean age 71.9 years) included in the final analysis, 114 (57.6%) had at least 1 mucosal break. Multivariate analysis identified protein pump inhibitor (PPI) use (OR 2.04; 95% confidence interval [CI], 1.05-3.97) and use of enteric-coated aspirin (OR 4.05; 95% CI, 1.49-11.0) as independent risk factors for the presence of mucosal breaks.
LIMITATIONS: Cross-sectional study.
CONCLUSION: PPI use appears to increase the risk of small-bowel injury in patients who take continuous low-dose aspirin. Clinicians should be aware of this effect of PPIs; new strategies are needed to treat aspirin-induced gastroenteropathy.