Gastro-duodenal mucosal changes associated with low-dose aspirin therapy: a prospective, endoscopic study

Area of Science:

• Gastroenterology
• Pharmacology
• Endoscopy

Background:

• Low-dose aspirin is widely used for cardiovascular prevention.
• Gastrointestinal bleeding is a known risk, but gastroduodenal mucosal changes require further evaluation.
• Prospective endoscopic studies are needed to assess aspirin-induced mucosal damage.

Purpose of the Study:

• To prospectively evaluate gastroduodenal mucosal lesions associated with low-dose aspirin therapy.
• To compare mucosal changes induced by plain versus enteric-coated aspirin.
• To assess the temporal evolution of aspirin-induced gastroduodenal lesions.

Main Methods:

• A randomized, prospective endoscopic study involving 47 patients receiving 150 mg/day of either plain or enteric-coated aspirin.
• Follow-up upper gastrointestinal endoscopy at 2, 4, and 8 weeks.
• Comparison with 47 control patients with hemorrhagic infarct not on aspirin.

Main Results:

• 60% of aspirin recipients developed mucosal lesions, most commonly in the stomach.
• No significant difference in lesion frequency between plain (63.6%) and enteric-coated (56%) aspirin.
• Gastric mucosal changes were significantly less frequent at 8 weeks (19%) compared to 2 weeks (53%) and 4 weeks (55%).

Conclusions:

• Low-dose aspirin, regardless of formulation, induces endoscopic gastroduodenal mucosal lesions in a majority of patients.
• The frequency of these lesions diminishes over an 8-week treatment period.
• Enteric-coated and plain aspirin show similar propensity to induce mucosal damage.