Gastroduodenal Mucosal Injury Profile in Long-Term Low-Dose Aspirin Users and Its Influencing Factors
Abstract: Low-dose aspirin is
the most common drug used for prevention of cardiovascular and cerebrovascular
events. Long-term aspirin therapy can induce gastroduodenal mucosal injury,
even in a very low dose (10 mg daily). The frequency of gastroduodenal injuries
among long-term low-dose aspirin users in Indonesia is currently unknown. The
aim of this study is to determine the prevalence of gastroduodenal mucosal
injury, endoscopic findings, and influencing factors among long-term low-dose
aspirin users in Cipto Mangunkusumo Hospital.
Method: This study was a cross-sectional study conducted in Cipto
Mangunkusumo Hospital, Jakarta. Subjects were patients aged ≥ 18 years old who
had been using low-dose aspirin (75-325 mg) for at least the preceding 28 days.
Ninety-five subjects were recruited consecutively in the period of December
2015 – April 2016. History taking, upper endoscopic examination, and
histopathology examination for Helicobacter pylori infection were performed in
all subjects. Endoscopic findings such as erosions and ulcers were assessed as
mucosal injuries. Data were analysed to find prevalence, bivariate analysis
(Chi-square test), and multivariate analysis (logistic regression test).
Results: Mucosal injury was found in 49 subjects (51.6%; 95% CI:
41.6–61.7%), mucosal erosion in 38 subjects (40%; 95% CI: 30.2–49.9%) and
ulcers in 11 subjects (11.6%; 95% CI: 5.2–18.0%). Only 44.9% patients with
mucosal injury had dyspepsia symptoms. Double antiplatelet therapy increased
the risk of mucosal injury (OR = 3.3; 95% CI: 1.3–8.5). However, proton pump
inhibitor (PPI) decreased the risk of mucosal injury (OR = 0,2; 95% CI: 0,04 –
0,60).
Conclusion: Gastroduodenal mucosal injury was found in more than half of
long-term low-dose aspirin users. Double antiplatelet therapy increased the
risk of mucosal injury, while PPI effectively reduced the risk.
Keywords: low-dose aspirin;
gastroduodenal mucosal injury; endoscopy
Author: Franciscus Ari, Ari
Fahrial Syam, Dadang Makmun, Suhendro
Journal Code: jpkedokterangg160419
