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Aspirin linked to increased risk for lower GI bleeding
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Low-dose aspirin users are at an increased risk for lower gastrointestinal bleeding compared with non-aspirin users, according to the results of a nationwide study in Taiwan.
The investigators also found that NSAIDs, steroids, SSRIs, PPIs and H2Ras were independently associated with risk for lower GI bleeding.
While “increasing evidence has demonstrated that [aspirin] users are at a risk of lower gastrointestinal bleeding ... [this risk] has rarely been investigated on a large scale,” they wrote.
Therefore, they identified 53,805 individuals within a national registry who took 75 mg to 325 mg aspirin daily, and compared their risk for lower GI bleeding with 269,025 controls matched by age, sex and time of enrollment from 2000 through 2006.
The incidence rate of lower GI bleeding was higher among aspirin users within 1 year (0.2%) compared with controls (0.06%; P < .0001).
After adjusting for a variety of factors, the investigators found use of aspirin (HR = 2.75; 95% CI, 2.06-3.65), NSAIDs (HR = 8.61; 95% CI, 3.28-22.58), steroids (HR = 10.5; 95% CI, 1.98-55.57), SSRIs (HR = 11.71; 95% CI, 1.4-97.94), PPIs (HR = 8.47; 95% CI, 2.26-31.71) and H2Ras (HR = 10.83; 95% CI, 2.98-39.33) were all significant independent risk factors for lower GI bleeding.
“Although the risk is low, the present findings may facilitate the management of low-dose [aspirin] users,” the researchers concluded. “Patients requiring antiplatelet therapy should be informed about the risk of [lower GI bleeding] before low-dose [aspirin] use, and a strategy should be developed to prevent and monitor [lower GI bleeding] in low-dose [aspirin] users.” – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.
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