Prior oral proton-pump inhibitor use is associated with reduced severity of aspirin-related upper gastrointestinal bleeding in older people.

Abstract

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.

• Authors: Oyekoya T Ayonrinde, Natasha Walldorf, Nicholas Chan, Nathanael Y Foo, Tithi Kulkarni, John K Olynyk, Frank M Sanfilippo
• Journal: Internal medicine journal (Intern Med J) Vol. 52 Issue 4 Pg. 663-666 (04 2022) ISSN: 1445-5994 [Electronic] Australia
• PMID: 35419961 (Publication Type: Journal Article)
• Copyright: © 2022 Royal Australasian College of Physicians.

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Proton Pump Inhibitors
• Aspirin

Topics

• Aged
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects)
• Aspirin (adverse effects)
• Gastrointestinal Hemorrhage (chemically induced, epidemiology)
• Humans
• Proton Pump Inhibitors (adverse effects)
• Risk Factors
• Secondary Prevention