Key result
Regular PPI use linked to ~90% less upper GI bleeding in aspirin users ≥70 years.
Why the study?
Low-dose aspirin is commonly used for cardiovascular disease prophylaxis in older people, but its risk of upper gastrointestinal ulceration and bleeding is often not appreciated.
Does regular proton-pump inhibitor use reduce the likelihood of overt upper gastrointestinal bleeding in older patients taking low-dose aspirin?
Observational (n=133)
Does regular proton-pump inhibitor use reduce the likelihood of overt upper gastrointestinal bleeding in older patients taking low-dose aspirin?
Effect estimate: OR 0.10
Regular proton-pump inhibitor use is associated with a 90% reduction in the likelihood of overt upper gastrointestinal bleeding among older patients taking low-dose aspirin.
May support PPI gastroprotection in elderly aspirin users; leaves open causal confirmation in RCTs.
Low-dose aspirin is commonly used for primary or secondary prophylaxis against cardiovascular disease in older people. However, the potential risk of upper gastrointestinal (UGI) ulceration and bleeding associated with low-dose aspirin use is often not appreciated by prescribers and older consumers. Among 133 serial patients with UGI bleeding, aspirin-users aged ≥70 years had a ninefold increased likelihood of overt UGI bleeding compared with non-users, reducing by 90% in regular proton-pump inhibitor users (adjusted odds ratio 0.10). We recommend risk-versus-benefit discussions when recommending aspirin to older people.
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Ayonrinde et al. (2022) conducted an observational in Upper gastrointestinal bleeding (n=133). Proton-pump inhibitor vs. Non-users was evaluated on Overt upper gastrointestinal bleeding (OR 0.10). Regular proton-pump inhibitor use reduced the likelihood of overt upper gastrointestinal bleeding by 90% among aspirin users aged ≥70 years (adjusted OR 0.10).
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