Risk of Peptic Ulcer Bleeding Associated with Infection, Nonsteroidal Anti-inflammatory Drugs, and Low-dose Aspirin Therapy in Peptic Ulcer Disease: A Case-control Study
Background/Aims The association between Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin therapy as a risk factor for peptic ulcer bleeding (PUB) remains unclear. This study investigated the risk of PUB associated with H. pylori infection and NSAID...
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Korean College of Helicobacter and Upper Gastrointestinal Research
2019-03-01
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| Series: | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
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| Online Access: | http://helicojournal.org/upload/pdf/kjhur-19-1-42.pdf |
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| author | Seung In Seo Jin Gu Kang Hyoung Su Kim Woon Geon Shin Myoung Kuk Jang Jin Heon Lee Hak Yang Kim |
| author_facet | Seung In Seo Jin Gu Kang Hyoung Su Kim Woon Geon Shin Myoung Kuk Jang Jin Heon Lee Hak Yang Kim |
| author_sort | Seung In Seo |
| collection | DOAJ |
| description | Background/Aims The association between Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin therapy as a risk factor for peptic ulcer bleeding (PUB) remains unclear. This study investigated the risk of PUB associated with H. pylori infection and NSAID or low-dose aspirin therapy in patients with PUD. Materials and Methods This case-control study investigated 340 patients with PUB between 2012 and 2016. The control group comprised age and sex-matched patients with endoscopically documented non-bleeding ulcers. Using logistic regression analysis, the adjusted odds ratio (AOR) was calculated for the risk of PUB. Results Of the patients investigated, 57.9% in the study group and Results Of the patients investigated, 57.9% in the study group and 51.8% in the control group were diagnosed with H. pylori infection (P=0.106). Logistic regression analysis showed synergistic interaction between H. pylori infection and low-dose aspirin therapy. Multivariate analysis showed that low-dose aspirin (AOR 3.92, P=0.001), NSAIDs (AOR 2.98, P=0.001), warfarin (AOR 14.57, P=0.011), gastric ulcer (compared with duodenal ulcer) (AOR 1.65, P=0.01), and smoking (AOR 1.97, P=0.004) increased the risk of PUB compared with the risk of PUD.Conclusions: Both NSAIDs and aspirin are independent risk factors for bleeding in patients with PUD. Additionally, low-dose aspirin therapy concomitant with H. pylori infection produced a synergistic effect. Therefore, H. pylori eradication may be crucial in aspirin users. Moreover, a proton pump inhibitor should be prescribed in patients with a history of bleeding ulcers who need long-term NSAID treatment. |
| format | Article |
| id | doaj-art-a574b548b6c44bf68bf81f6be8d08554 |
| institution | Kabale University |
| issn | 1738-3331 |
| language | English |
| publishDate | 2019-03-01 |
| publisher | Korean College of Helicobacter and Upper Gastrointestinal Research |
| record_format | Article |
| series | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
| spelling | doaj-art-a574b548b6c44bf68bf81f6be8d085542025-08-20T03:35:53ZengKorean College of Helicobacter and Upper Gastrointestinal ResearchThe Korean Journal of Helicobacter and Upper Gastrointestinal Research1738-33312019-03-01191424710.7704/kjhugr.2019.19.1.42559Risk of Peptic Ulcer Bleeding Associated with Infection, Nonsteroidal Anti-inflammatory Drugs, and Low-dose Aspirin Therapy in Peptic Ulcer Disease: A Case-control StudySeung In Seo0Jin Gu Kang1Hyoung Su Kim2Woon Geon Shin3Myoung Kuk Jang4Jin Heon Lee5Hak Yang Kim Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, KoreaBackground/Aims The association between Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin therapy as a risk factor for peptic ulcer bleeding (PUB) remains unclear. This study investigated the risk of PUB associated with H. pylori infection and NSAID or low-dose aspirin therapy in patients with PUD. Materials and Methods This case-control study investigated 340 patients with PUB between 2012 and 2016. The control group comprised age and sex-matched patients with endoscopically documented non-bleeding ulcers. Using logistic regression analysis, the adjusted odds ratio (AOR) was calculated for the risk of PUB. Results Of the patients investigated, 57.9% in the study group and Results Of the patients investigated, 57.9% in the study group and 51.8% in the control group were diagnosed with H. pylori infection (P=0.106). Logistic regression analysis showed synergistic interaction between H. pylori infection and low-dose aspirin therapy. Multivariate analysis showed that low-dose aspirin (AOR 3.92, P=0.001), NSAIDs (AOR 2.98, P=0.001), warfarin (AOR 14.57, P=0.011), gastric ulcer (compared with duodenal ulcer) (AOR 1.65, P=0.01), and smoking (AOR 1.97, P=0.004) increased the risk of PUB compared with the risk of PUD.Conclusions: Both NSAIDs and aspirin are independent risk factors for bleeding in patients with PUD. Additionally, low-dose aspirin therapy concomitant with H. pylori infection produced a synergistic effect. Therefore, H. pylori eradication may be crucial in aspirin users. Moreover, a proton pump inhibitor should be prescribed in patients with a history of bleeding ulcers who need long-term NSAID treatment.http://helicojournal.org/upload/pdf/kjhur-19-1-42.pdfAspirinNonsteroidal anti-inflammatory agentsPeptic ulcer |
| spellingShingle | Seung In Seo Jin Gu Kang Hyoung Su Kim Woon Geon Shin Myoung Kuk Jang Jin Heon Lee Hak Yang Kim Risk of Peptic Ulcer Bleeding Associated with Infection, Nonsteroidal Anti-inflammatory Drugs, and Low-dose Aspirin Therapy in Peptic Ulcer Disease: A Case-control Study The Korean Journal of Helicobacter and Upper Gastrointestinal Research Aspirin Nonsteroidal anti-inflammatory agents Peptic ulcer |
| title | Risk of Peptic Ulcer Bleeding Associated with Infection, Nonsteroidal Anti-inflammatory Drugs, and Low-dose Aspirin Therapy in Peptic Ulcer Disease: A Case-control Study |
| title_full | Risk of Peptic Ulcer Bleeding Associated with Infection, Nonsteroidal Anti-inflammatory Drugs, and Low-dose Aspirin Therapy in Peptic Ulcer Disease: A Case-control Study |
| title_fullStr | Risk of Peptic Ulcer Bleeding Associated with Infection, Nonsteroidal Anti-inflammatory Drugs, and Low-dose Aspirin Therapy in Peptic Ulcer Disease: A Case-control Study |
| title_full_unstemmed | Risk of Peptic Ulcer Bleeding Associated with Infection, Nonsteroidal Anti-inflammatory Drugs, and Low-dose Aspirin Therapy in Peptic Ulcer Disease: A Case-control Study |
| title_short | Risk of Peptic Ulcer Bleeding Associated with Infection, Nonsteroidal Anti-inflammatory Drugs, and Low-dose Aspirin Therapy in Peptic Ulcer Disease: A Case-control Study |
| title_sort | risk of peptic ulcer bleeding associated with infection nonsteroidal anti inflammatory drugs and low dose aspirin therapy in peptic ulcer disease a case control study |
| topic | Aspirin Nonsteroidal anti-inflammatory agents Peptic ulcer |
| url | http://helicojournal.org/upload/pdf/kjhur-19-1-42.pdf |
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