Proton pump inhibitors are associated with lower gastrointestinal tract bleeding in low-dose aspirin users with ischaemic heart disease. Issue 9 (September 2015)

• Record Type: Journal Article
• Authors: Miyake, Kazumasa; Akimoto, Teppei; Hanada, Yuriko; Nagoya, Hiroyuki; Kodaka, Yasuhiro; Ueki, Nobue; Kusunoki, Masafumi; Kawagoe, Tetsuro; Futagami, Seiji; Takahashi, Yasuhiro; Takano, Hitoshi; Sakamoto, Choitsu
• Is Part Of: Digestive and liver disease. Volume 47:Issue 9(2015)
• Page Start: 757
• Page End: 762
• Publication Date: 2015-09
• Subjects: Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2015.05.020
• Languages: English
• ISSNs: 1590-8658

Abstract

<abstract abstract-type="author" id="abs0005"> <title id="sect0005">Abstract</title> <sec> <title id="sect0010">Background</title> <p id="spar0005">Impact of acid suppressants on lower gastrointestinal bleeding remains unclear in low-dose aspirin users; we aimed to investigate this relationship.</p> </sec> <sec> <title id="sect0015">Methods</title> <p id="spar0010">Retrospective cohort study of low-dose aspirin users who underwent coronary angiography for ischaemic heart disease in our institution between October 2005 and December 2006; patients were evaluated for upper or lower gastrointestinal bleedings within 3 years post-angiography.</p> </sec> <sec> <title id="sect0020">Results</title> <p id="spar0015">538 patients were enrolled (males, 74.4%; mean age 67.4 ± 10.6 years). Risk for upper gastrointestinal bleeding decreased with concomitant use of statins (HR, 0.37; 95% CI, 0.15–0.89), calcium channel blockers (HR, 0.29; 95% CI, 0.10–0.85), and histamine-2 receptor antagonists (HR, 0.26; 95% CI, 0.08–0.89). Concomitant use of proton pump inhibitors tended to decrease risk of upper gastrointestinal bleeding (HR, 0.27; 95% CI, 0.06–1.18). Risk for lower gastrointestinal bleeding increased with both concomitant use of warfarin (HR, 15.68; 95% CI, 4.43–55.53) and proton pump inhibitors (HR, 6.55; 95% CI, 2.01–21.32), but not with histamine-2 receptor antagonists. Hyperuricemia lowered risk for lower gastrointestinal bleeding (HR, 0.12; 95% CI, 0.02–0.88).</p> </sec> <sec> <title id="sect0025">Conclusions</title> <p id="spar0020">In low-dose aspirin users, concomitant use of proton pump inhibitors increased lower gastrointestinal bleeding risk, independent from effects on upper gastrointestinal bleeding.</p> </sec> </abstract>