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. 1995 Apr 1;310(6983):827–830. doi: 10.1136/bmj.310.6983.827

Prophylactic aspirin and risk of peptic ulcer bleeding.

J Weil 1, D Colin-Jones 1, M Langman 1, D Lawson 1, R Logan 1, M Murphy 1, M Rawlins 1, M Vessey 1, P Wainwright 1
PMCID: PMC2549215  PMID: 7711618

Abstract

OBJECTIVE--To determine the risks of hospitalisation for bleeding peptic ulcer with the current prophylactic aspirin regimens of 300 mg daily or less. DESIGN--A case-control study with hospital and community controls. SETTING--Hospitals in Glasgow, Newcastle, Nottingham, Oxford, and Portsmouth. SUBJECTS--1121 patients with gastric or duodenal ulcer bleeding matched with hospital and community controls. RESULTS--144 (12.8%) cases had been regular users of aspirin (taken at least five days a week for at least the previous month) compared with 101 (9.0%) hospital and 77 (7.8%) community controls. Odds ratios were raised for all doses of aspirin taken, whether compared with hospital or community controls (compared with combined controls: 75 mg, 2.3 (95% confidence interval 1.2 to 4.4); 150 mg, 3.2 (1.7 to 6.5); 300 mg, 3.9 (2.5 to 6.3)). Results were not explained by confounding influences of age, sex, prior ulcer history or dyspepsia, or concurrent non-aspirin non-steroidal anti-inflammatory drug use. Risks seemed particularly high in patients who took non-aspirin non-steroidal anti-inflammatory drugs concurrently. CONCLUSION--No conventionally used prophylactic aspirin regimen seems free of the risk of peptic ulcer complications.

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Selected References

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  1. ALLIBONE A., FLINT F. J. Bronchitis, aspirin, smoking, and other factors in the aetiology of peptic ulcer. Lancet. 1958 Jul 26;2(7039):179–182. doi: 10.1016/s0140-6736(58)91526-5. [DOI] [PubMed] [Google Scholar]
  2. Bjarnason I., Price A. B., Zanelli G., Smethurst P., Burke M., Gumpel J. M., Levi A. J. Clinicopathological features of nonsteroidal antiinflammatory drug-induced small intestinal strictures. Gastroenterology. 1988 Apr;94(4):1070–1074. doi: 10.1016/0016-5085(88)90568-9. [DOI] [PubMed] [Google Scholar]
  3. Bjarnason I., Zanelli G., Smith T., Prouse P., Williams P., Smethurst P., Delacey G., Gumpel M. J., Levi A. J. Nonsteroidal antiinflammatory drug-induced intestinal inflammation in humans. Gastroenterology. 1987 Sep;93(3):480–489. doi: 10.1016/0016-5085(87)90909-7. [DOI] [PubMed] [Google Scholar]
  4. Bousser M. G., Eschwege E., Haguenau M., Lefaucconnier J. M., Thibult N., Touboul D., Touboul P. J. "AICLA" controlled trial of aspirin and dipyridamole in the secondary prevention of athero-thrombotic cerebral ischemia. Stroke. 1983 Jan-Feb;14(1):5–14. doi: 10.1161/01.str.14.1.5. [DOI] [PubMed] [Google Scholar]
  5. Breddin K., Loew D., Lechner K., Uberla K., Walter E. Secondary prevention of myocardial infarction: a comparison of acetylsalicylic acid, placebo and phenprocoumon. Haemostasis. 1980;9(6):325–344. doi: 10.1159/000214375. [DOI] [PubMed] [Google Scholar]
  6. Cairns J. A., Gent M., Singer J., Finnie K. J., Froggatt G. M., Holder D. A., Jablonsky G., Kostuk W. J., Melendez L. J., Myers M. G. Aspirin, sulfinpyrazone, or both in unstable angina. Results of a Canadian multicenter trial. N Engl J Med. 1985 Nov 28;313(22):1369–1375. doi: 10.1056/NEJM198511283132201. [DOI] [PubMed] [Google Scholar]
  7. Coggon D., Langman M. J., Spiegelhalter D. Aspirin, paracetamol, and haematemesis and melaena. Gut. 1982 Apr;23(4):340–344. doi: 10.1136/gut.23.4.340. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Elwood P. C., Cochrane A. L., Burr M. L., Sweetnam P. M., Williams G., Welsby E., Hughes S. J., Renton R. A randomized controlled trial of acetyl salicylic acid in the secondary prevention of mortality from myocardial infarction. Br Med J. 1974 Mar 9;1(5905):436–440. doi: 10.1136/bmj.1.5905.436. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Elwood P. C., Sweetnam P. M. Aspirin and secondary mortality after myocardial infarction. Lancet. 1979 Dec 22;2(8156-8157):1313–1315. doi: 10.1016/s0140-6736(79)92808-3. [DOI] [PubMed] [Google Scholar]
  10. Faulkner G., Prichard P., Somerville K., Langman M. J. Aspirin and bleeding peptic ulcers in the elderly. BMJ. 1988 Nov 19;297(6659):1311–1313. doi: 10.1136/bmj.297.6659.1311. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Langman M. J., Morgan L., Worrall A. Use of anti-inflammatory drugs by patients admitted with small or large bowel perforations and haemorrhage. Br Med J (Clin Res Ed) 1985 Feb 2;290(6465):347–349. doi: 10.1136/bmj.290.6465.347. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Langman M. J., Weil J., Wainwright P., Lawson D. H., Rawlins M. D., Logan R. F., Murphy M., Vessey M. P., Colin-Jones D. G. Risks of bleeding peptic ulcer associated with individual non-steroidal anti-inflammatory drugs. Lancet. 1994 Apr 30;343(8905):1075–1078. doi: 10.1016/s0140-6736(94)90185-6. [DOI] [PubMed] [Google Scholar]
  13. Laporte J. R., Carné X., Vidal X., Moreno V., Juan J. Upper gastrointestinal bleeding in relation to previous use of analgesics and non-steroidal anti-inflammatory drugs. Catalan Countries Study on Upper Gastrointestinal Bleeding. Lancet. 1991 Jan 12;337(8733):85–89. doi: 10.1016/0140-6736(91)90744-a. [DOI] [PubMed] [Google Scholar]
  14. Levy M., Miller D. R., Kaufman D. W., Siskind V., Schwingl P., Rosenberg L., Strom B., Shapiro S. Major upper gastrointestinal tract bleeding. Relation to the use of aspirin and other nonnarcotic analgesics. Arch Intern Med. 1988 Feb;148(2):281–285. doi: 10.1001/archinte.148.2.281. [DOI] [PubMed] [Google Scholar]
  15. Meade T. W., Roderick P. J., Brennan P. J., Wilkes H. C., Kelleher C. C. Extra-cranial bleeding and other symptoms due to low dose aspirin and low intensity oral anticoagulation. Thromb Haemost. 1992 Jul 6;68(1):1–6. [PubMed] [Google Scholar]
  16. Petersen P., Boysen G., Godtfredsen J., Andersen E. D., Andersen B. Placebo-controlled, randomised trial of warfarin and aspirin for prevention of thromboembolic complications in chronic atrial fibrillation. The Copenhagen AFASAK study. Lancet. 1989 Jan 28;1(8631):175–179. doi: 10.1016/s0140-6736(89)91200-2. [DOI] [PubMed] [Google Scholar]
  17. Prichard P. J., Kitchingman G. K., Walt R. P., Daneshmend T. K., Hawkey C. J. Human gastric mucosal bleeding induced by low dose aspirin, but not warfarin. BMJ. 1989 Feb 25;298(6672):493–496. doi: 10.1136/bmj.298.6672.493. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Roderick P. J., Wilkes H. C., Meade T. W. The gastrointestinal toxicity of aspirin: an overview of randomised controlled trials. Br J Clin Pharmacol. 1993 Mar;35(3):219–226. doi: 10.1111/j.1365-2125.1993.tb05689.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Somerville K., Faulkner G., Langman M. Non-steroidal anti-inflammatory drugs and bleeding peptic ulcer. Lancet. 1986 Mar 1;1(8479):462–464. doi: 10.1016/s0140-6736(86)92927-2. [DOI] [PubMed] [Google Scholar]
  20. Sorensen P. S., Pedersen H., Marquardsen J., Petersson H., Heltberg A., Simonsen N., Munck O., Andersen L. A. Acetylsalicylic acid in the prevention of stroke in patients with reversible cerebral ischemic attacks. A Danish cooperative study. Stroke. 1983 Jan-Feb;14(1):15–22. [PubMed] [Google Scholar]

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