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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Piazuelo, Elena Fuentes, Javier García-González, María Asunción Jiménez, Pilar Lanas, Angel |
| Description | Country affiliation: Spain Author Affiliation: Piazuelo E ( Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain. epiazor@unizar.es) |
| Abstract | BACKGROUND: Previous studies have reported a potential genetic predisposition to NSAID-related upper gastrointestinal (GI) bleeding. OBJECTIVE: This study evaluated whether there was an association between 2 polymorphisms--the platelet glycoprotein (GP) IIIa PlA1/A2 polymorphism and the 27-bp VNTR (variable number of tandem repeats) polymorphism in intron 4 of the endothelial nitric oxide synthase (eNOS) gene--and a risk for nonvariceal upper GI bleeding in Spanish patients taking low-dose aspirin for secondary prophylaxis of vascular occlusive diseases. METHODS: Genotyping for the 2 polymorphisms was performed in patients hospitalized for upper GI bleeding associated with the use of low-dose aspirin between September 1998 and October 2000, and race-, age-, and sex-matched controls who were taking low-dose aspirin but had no history of upper GI bleeding. To ascertain allele frequencies in a healthy population, genotyping was also performed in an unmatched group of blood donors. RESULTS: The study included 88 white patients (65 men, 23 women; mean age, 67.5 years) with an episode of upper GI bleeding, 108 matched controls with no history of upper GI bleeding (79 men, 29 women; mean age, 65.9 years), and 158 blood-donor controls (109 men, 49 women; mean age, 53.4 years). No significant differences were found between cases and controls in terms of genotype, carriage, or allele frequency of the GPIIIa PlA1/A2 polymorphism. However, after adjustment for confounding variables, logistic regression analysis indicated an association between carriage of the eNOS 'a' allele and a reduced risk of upper GI bleeding (odds ratio [OR] 0.39; 95 CI, 0.18-0.85; P 0.018). In this model, treatment with nitrovasodilators (OR 0.28; 95 CI, 0.12-0.66; P 0.004) and use of antisecretory drugs (OR 0.15; 95 CI, 0.05-0.47; P 0.001) were also identified as protective factors. Helicobacter pylori infection (OR 3.07; 95 CI, 1.23-7.70; P 0.017), alcohol consumption (OR 5.04; 95 CI, 1.86-13.70; P 0.001), and a history of peptic ulcer (OR 13.41; 95 CI, 3.78-47.64; P 0.001) were identified as risk factors for upper GI bleeding. CONCLUSION: In this small, selected population of individuals taking low-dose aspirin for secondary prevention, carriage of the 'a' allele of the eNOS gene was associated with a decreased risk for upper GI bleeding. |
| File Format | HTM / HTML |
| ISSN | 01492918 |
| Issue Number | 1 |
| Volume Number | 30 |
| e-ISSN | 1879114X |
| Journal | Clinical Therapeutics |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2008-01-01 |
| Publisher Place | United States |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Pharmacology Aspirin Adverse Effects Gastrointestinal Hemorrhage Genetics Integrin Beta3 Nitric Oxide Synthase Type Iii Platelet Aggregation Inhibitors Polymorphism, Genetic Aged Alcohol Drinking Administration & Dosage Case-control Studies Female Chemically Induced Gene Frequency Genetic Predisposition To Disease Genotype Helicobacter Infections Complications Humans Introns Male Middle Aged Peptic Ulcer Risk Factors Vasodilator Agents Therapeutic Use Journal Article Research Support, Non-u.s. Gov't |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pharmacology Pharmacology (medical) |
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