Helicobacter pylori infection independently increased the risk of upper gastrointestinal bleeding in patients taking low-dose aspirin (OR 4.7; 95% CI 2.0-10.9).
Case-Control (n=245)
Does Helicobacter pylori infection increase the risk of upper gastrointestinal bleeding in patients taking low-dose aspirin?
Helicobacter pylori infection significantly increases the risk of upper gastrointestinal bleeding in patients taking low-dose aspirin, suggesting potential therapeutic implications for high-risk patients.
Odds Ratio: 4.7 (95% CI 2–10.9)
AIM: To evaluate the role of Helicobacter pylori infection and other clinical factors in the risk of upper gastrointestinal bleeding in patients taking low-dose aspirin. SUBJECTS AND METHODS: A case-control study was carried out of consecutive current users of low-dose aspirin admitted because of upper gastrointestinal bleeding. Within a cohort of 695 patients with upper gastrointestinal bleeding, 98 patients had taken low-dose aspirin and no other non-steroidal anti-inflammatory drug. Controls were 147 low-dose aspirin users without upper gastrointestinal bleeding of similar age, sex and extent of aspirin use as cases. H. pylori infection was determined by CagA/VacA serology and 13C-urea breath test in all cases and controls. Adjusted odds ratios (OR) are provided. RESULTS: H. pylori infection was identified as an independent risk factor of upper gastrointestinal bleeding in this population (OR, 4.7; 95% confidence interval (95% CI), 2.0-10.9), but the presence of CagA-positive serology was not. Other risk factors identified were a previous ulcer history (OR, 15.2; 95% CI, 3.8-60.1), alcohol use (OR, 4.2; 95% CI, 1.7-10.4) and use of calcium channel blockers (OR, 2.54; 95% CI, 1.25-5.14). Antisecretory therapy (OR, 0.1; 95% CI, 0.02-0.3) and nitrovasodilators (OR, 0.2; 95% CI, 0.1-0.6) decreased the risk of bleeding. CONCLUSIONS: H. pylori infection is a risk factor for upper gastrointestinal bleeding in low-dose aspirin users, which might have therapeutic implications in high-risk patients.
Lanas et al. (2002) conducted a case-control in Upper gastrointestinal bleeding in low-dose aspirin users (n=245). Helicobacter pylori infection vs. No Helicobacter pylori infection was evaluated on Upper gastrointestinal bleeding (OR 4.7, 95% CI 2.0-10.9). Helicobacter pylori infection independently increased the risk of upper gastrointestinal bleeding in patients taking low-dose aspirin (OR 4.7; 95% CI 2.0-10.9).