SAN ANTONIO (EGMN) – Men who took more than 14 aspirin per week were more than twice as likely to report upper gastrointestinal bleeding as were men who reported no aspirin use, but increased duration of use did not appear to raise the risk of GI bleeding, Dr. Edward Huang said at the annual meeting of the American College of Gastroenterology.

Evidence regarding the impact of aspirin use on GI bleeding is conflicting because of the limitations of previous studies, said Dr. Huang of Massachusetts General Hospital in Boston.

To examine the long-term effects of aspirin dose and duration on GI bleeding, Dr. Huang and his colleagues conducted a prospective study of 32,989 participants in the Health Professionals Follow-up Study, a longitudinal study of male health professionals in the United States. In 2006 and 2008, participants were asked to report any past episodes of GI bleeding severe enough to require hospitalization or blood transfusion.

During a mean 14-year follow-up period, 707 men had an episode of major GI bleeding. After adjustment for risk factors including use of NSAIDs, age, smoking status, exercise, and body mass index, the risk ratios for upper GI bleeding were 1.05 for men who took 0.5-1.5 standard aspirin tablets (325 mg) per week, 1.31 for those who took 2-5 tablets per week, 1.63 for those who took 6-14 tablets per week, and 2.40 for those who took more than 14 tablets per week, compared with men who reported no aspirin use.

Short-term aspirin use was defined as less than 5 years, and long-term use was defined as 5 years or longer. “The dose-response relationship is significant regardless of duration of use,” Dr. Huang noted.

By contrast, longer duration of use was not significantly associated with an increased risk of upper GI bleeding, Dr. Huang said. However, individuals who use aspirin the longest tend to use the highest dose, he added.

The study was limited by the self-selected aspirin use on the part of the participants, but Dr. Huang emphasized that the participants were well-educated health professionals. Although the study included men only, he noted that similar reviews of data from the Nurses’ Health Study have yielded similar findings.

The average age of the men when they enrolled in the study was 60 years, and those with a history of peptic ulcer disease were excluded.

The results suggest that both short-term and long-term aspirin users can minimize the risk of upper GI bleeding by using the lowest effective dose, Dr. Huang said.

Dr. Huang had no financial conflicts to disclose.

Copyright (c) 2010 Elsevier Global Medical News. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

圣安东尼奥(EGMN)——波士顿麻省总医院Edward Huang博士在美国胃肠病学会年会上报告称，每周服用14片阿司匹林的男性上消化道出血风险较不服用者高出2倍多，但是用药持续时间延长并不增加消化道出血风险。

 

由于此前相关研究有限，因而有关阿司匹林对消化道出血影响的证据并不一致。为了考察阿司匹林用药剂量和用药持续时间对消化道出血的长期影响，研究者对参与随访研究的32,989例男性进行了前瞻性研究。平均年龄60岁，消化性溃疡疾病患者被排除，平均随访时间14年。研究者分别在2006年和2008年要求参与者报告此前发生的需要住院或输血治疗的消化道出血事件。

 

结果显示，随访期间共有707例发生消化道出血事件。调整非甾体抗炎药物使用、年龄、吸烟状况、锻炼以及体重指数等危险因素后，每周服用0.5~1.5片、2~5片、6~14片和14片以上阿司匹林(325 mg/片)的男性与不服药者相比，上消化道出血风险比分别为1.05、1.31、1.63和2.40。无论短期(用药时间<5年)还是长期(用药时间≥5年) 服用阿司匹林，剂量效应关系均显著。然而，用药时间延长与上消化道出血风险增加无显著相关性。

 

该研究表明，无论短期还是长期服用阿司匹林，服用最小有效剂量可使上消化道出血风险降至最小程度。

 

Huang博士无经济利益冲突声明。

 

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