The risk of acute major upper gastrointestinal bleeding among users of aspirin and ibuprofen at various levels of alcohol consumption

Citation
Dw. Kaufman et al., The risk of acute major upper gastrointestinal bleeding among users of aspirin and ibuprofen at various levels of alcohol consumption, AM J GASTRO, 94(11), 1999, pp. 3189-3196
Citations number
18
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenerology and Hepatology
Journal title
AMERICAN JOURNAL OF GASTROENTEROLOGY
ISSN journal
0002-9270 → ACNP
Volume
94
Issue
11
Year of publication
1999
Pages
3189 - 3196
Database
ISI
SICI code
0002-9270(199911)94:11<3189:TROAMU>2.0.ZU;2-T
Abstract
OBJECTIVE: Major upper gastrointestinal bleeding (UGIB) is the most importa nt adverse effect of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs). Alcoholic beverages also precipitate UGIB. This analysis was con ducted to evaluate whether the deleterious effects of NSAIDs are further in creased among drinkers. METHODS: An interview-based, case-control study was conducted in the U.S. a nd Sweden; 1224 patients hospitalized with acute major UGIB due to newly oc curring peptic ulcer or gastritis were compared to 2945 neighbor controls. RESULTS: Compared with those who drank less than one drink/wk, the relative risk of acute UGIB increased with increasing alcohol consumption, rising t o 2.8 among those who drank greater than or equal to 21 drinks/wk. Among cu rrent drinkers, the relative risk of acute UGIB due to the use of aspirin w as raised at all levels of alcohol consumption; the estimate for aspirin ta ken at least every other day (regular use) at doses of >325 mg among all cu rrent drinkers combined was 7.0; for regular use at lower doses, the corres ponding estimate was 2.8, and for any occasional use, it was 2.4. All estim ates were statistically significant. Data for ibuprofen were more limited, but the relative risk estimates did not appear to vary consistently with le vel of alcohol consumption. For regular use tall doses combined), the estim ate among all drinkers combined was significantly elevated, at 2.7; occasio nal ibuprofen use was not associated with UGIB (1.2). There were insufficie nt data to evaluate other NSAIDs according to alcohol consumption. CONCLUSIONS: The findings suggest that acute UGIB is similarly associated w ith the use of the two most common nonprescription NSAIDs, aspirin and ibup rofen, at all levels of alcohol consumption. As heavy alcohol intake indepe ndently increases the risk, the incidence of UGIB is highest among persons who are both heavy drinkers and users of aspirin or ibuprofen. (C) 1999 by Am. Coil. of Gastroenterology.