Association between TNF‐α polymorphisms and the risk of upper gastrointestinal bleeding induced by aspirin in patients with coronary heart disease

Abstract

To investigate the correlation of tumor necrosis factor α (TNF-α) polymorphisms with upper gastrointestinal bleeding (UGIB) induced by enteric-coated aspirin in coronary heart disease (CHD) patients. In total, 154 CHD patients taking enteric-coated aspirin were enrolled in this study. Patients were divided into the UGIB group (n=57) and non-UGIB group (n=97) based on the presence or absence of signs of UGIB, respectively. TNF-α polymorphism (-857C>T, -863C>A, and -1031T>C) genotyping was performed using polymerase chain reaction (PCR) amplification with sequence-specific primers (PCR-SSP). Patients who had the CC genotype and C allele of -1031T>C exhibited a significantly increase risk of UGIB after receiving enteric-coated aspirin (CC vs. TT: odds (OR) (95% confidence interval (CI)): 7.568 (1.527-37.49), P=0.005; C vs. T: OR (95% CI): 1.852 (1.036-3.312), P=0.036). Patients who had CA and CA + AA genotypes and the A allele of -863C>A also exhibited an increased risk of aspirin-induced UGIB (CA vs. CC: OR (95% CI): 2.415 (1.143-5.101), P=0.019: CA + AA vs. CC: OR (95% CI): 2.218 (1.123-4.381), P=0.021; A vs. C: OR (95% CI): 1.788 (1.039-3.078), P=0.035). However, the TNF-α -857 C>T polymorphism was unrelated to the induction of UGIB by enteric-coated aspirin in CHD patients (P>0.05). In addition, the haplotypes of CCC (-1031T>C, -863C>A, and -857C>T) markedly reduced the risk of aspirin-induced UGIB in CHD patients. TNF-α -863A and -1031C increased the risk of UGIB induction by enteric-coated aspirin in CHD patients, whereas TNF-α -857C>T was not correlated with the UGIB risk.