Low-dose aspirin and risk of upper/lower gastrointestinal bleeding by bleed severity: a cohort study with nested case-control analysis using primary care electronic health records from the United Kingdom
Introduction Risks of low-dose aspirin-associated upper and lower gastrointestinal bleeds (UGIB/LGIB) may vary by severity and presence of cardiovascular disease (CVD). No study has quantified these risks for UGIB and LGIB in the same real-world study population.Patients and methods Using UK primary...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-02-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2019.1591635 |
| _version_ | 1811255918679031808 |
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| author | Luis A. García Rodríguez Angel Lanas Montse Soriano-Gabarró Lucía Cea Soriano |
| author_facet | Luis A. García Rodríguez Angel Lanas Montse Soriano-Gabarró Lucía Cea Soriano |
| author_sort | Luis A. García Rodríguez |
| collection | DOAJ |
| description | Introduction Risks of low-dose aspirin-associated upper and lower gastrointestinal bleeds (UGIB/LGIB) may vary by severity and presence of cardiovascular disease (CVD). No study has quantified these risks for UGIB and LGIB in the same real-world study population.Patients and methods Using UK primary care data, 199,049 new users of low-dose aspirin (75–300 mg/day) and 1:1 matched non-users were followed to identify incident UGIB (N = 1843)/LGIB (N = 2763) cases. Nested case-control analyses compared current low-dose aspirin vs. non-use on UGIB/LGIB risk.Results Adjusted incidence rate ratios (ORs; 95% CIs) were 1.62 (1.42–1.86) for non-fatal UGIB, 1.63 (1.47–1.81) for non-fatal LGIB, 0.77 (0.51–1.16) for fatal UGIB, 1.29 (0.50–3.36) for fatal LGIB. For hospitalizations, adjusted ORs (95% CIs) were 1.55 (1.32–1.81) for UGIB and 1.89 (1.58–2.27) for LGIB; for referred only cases, they were 1.52 (1.26–1.84) for UGIB and 1.54 (1.37–1.73) for LGIB. In primary CVD prevention, adjusted ORs (95% CI) were 1.62 (1.38–1.90) for UGIB and 1.60 (1.42–1.81) for LGIB; in secondary CVD prevention, they were 1.16 (0.89–1.50) for UGIB and 1.67 (1.34–2.09) for LGIB.Conclusion Low-dose aspirin was associated with increased risks of non-fatal but not fatal UGIB/LGIB.Key messageLow-dose aspirin is associated with an increased risks of non-fatal UGIB/LGIB but not fatal UGIB/LGIB. |
| first_indexed | 2024-04-12T17:31:07Z |
| format | Article |
| id | doaj.art-86bb8147416b486f86e25607cd8ce803 |
| institution | Directory Open Access Journal |
| issn | 0785-3890 1365-2060 |
| language | English |
| last_indexed | 2024-04-12T17:31:07Z |
| publishDate | 2019-02-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj.art-86bb8147416b486f86e25607cd8ce8032022-12-22T03:23:07ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602019-02-0151218219210.1080/07853890.2019.1591635Low-dose aspirin and risk of upper/lower gastrointestinal bleeding by bleed severity: a cohort study with nested case-control analysis using primary care electronic health records from the United KingdomLuis A. García Rodríguez0Angel Lanas1Montse Soriano-Gabarró2Lucía Cea Soriano3Spanish Centre for Pharmacoepidemiologic Research (CEIFE), Madrid, SpainServicio de Aparato Digestivo, Hospital Clínico, University of Zaragoza, IIS Aragón, Zaragoza, SpainEpidemiology, Bayer AG, Berlin, GermanySpanish Centre for Pharmacoepidemiologic Research (CEIFE), Madrid, SpainIntroduction Risks of low-dose aspirin-associated upper and lower gastrointestinal bleeds (UGIB/LGIB) may vary by severity and presence of cardiovascular disease (CVD). No study has quantified these risks for UGIB and LGIB in the same real-world study population.Patients and methods Using UK primary care data, 199,049 new users of low-dose aspirin (75–300 mg/day) and 1:1 matched non-users were followed to identify incident UGIB (N = 1843)/LGIB (N = 2763) cases. Nested case-control analyses compared current low-dose aspirin vs. non-use on UGIB/LGIB risk.Results Adjusted incidence rate ratios (ORs; 95% CIs) were 1.62 (1.42–1.86) for non-fatal UGIB, 1.63 (1.47–1.81) for non-fatal LGIB, 0.77 (0.51–1.16) for fatal UGIB, 1.29 (0.50–3.36) for fatal LGIB. For hospitalizations, adjusted ORs (95% CIs) were 1.55 (1.32–1.81) for UGIB and 1.89 (1.58–2.27) for LGIB; for referred only cases, they were 1.52 (1.26–1.84) for UGIB and 1.54 (1.37–1.73) for LGIB. In primary CVD prevention, adjusted ORs (95% CI) were 1.62 (1.38–1.90) for UGIB and 1.60 (1.42–1.81) for LGIB; in secondary CVD prevention, they were 1.16 (0.89–1.50) for UGIB and 1.67 (1.34–2.09) for LGIB.Conclusion Low-dose aspirin was associated with increased risks of non-fatal but not fatal UGIB/LGIB.Key messageLow-dose aspirin is associated with an increased risks of non-fatal UGIB/LGIB but not fatal UGIB/LGIB.https://www.tandfonline.com/doi/10.1080/07853890.2019.1591635Upper gastrointestinal bleedinglower gastrointestinal bleedingaspirin |
| spellingShingle | Luis A. García Rodríguez Angel Lanas Montse Soriano-Gabarró Lucía Cea Soriano Low-dose aspirin and risk of upper/lower gastrointestinal bleeding by bleed severity: a cohort study with nested case-control analysis using primary care electronic health records from the United Kingdom Annals of Medicine Upper gastrointestinal bleeding lower gastrointestinal bleeding aspirin |
| title | Low-dose aspirin and risk of upper/lower gastrointestinal bleeding by bleed severity: a cohort study with nested case-control analysis using primary care electronic health records from the United Kingdom |
| title_full | Low-dose aspirin and risk of upper/lower gastrointestinal bleeding by bleed severity: a cohort study with nested case-control analysis using primary care electronic health records from the United Kingdom |
| title_fullStr | Low-dose aspirin and risk of upper/lower gastrointestinal bleeding by bleed severity: a cohort study with nested case-control analysis using primary care electronic health records from the United Kingdom |
| title_full_unstemmed | Low-dose aspirin and risk of upper/lower gastrointestinal bleeding by bleed severity: a cohort study with nested case-control analysis using primary care electronic health records from the United Kingdom |
| title_short | Low-dose aspirin and risk of upper/lower gastrointestinal bleeding by bleed severity: a cohort study with nested case-control analysis using primary care electronic health records from the United Kingdom |
| title_sort | low dose aspirin and risk of upper lower gastrointestinal bleeding by bleed severity a cohort study with nested case control analysis using primary care electronic health records from the united kingdom |
| topic | Upper gastrointestinal bleeding lower gastrointestinal bleeding aspirin |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2019.1591635 |
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