Abstract
BackgroundIt is well established that long-term use of aspirin can cause gastric mucosal injury. ACEIs and ARBs are inversely related to gastric ulcer development. This study aimed to evaluate the relationship between SLCO1B1 polymorphisms, which can affect ACEI and ARB transport, and gastric mucosal erosion in elderly male Chinese patients with cardiovascular disease who use aspirin.MethodsPatients taking aspirin and an ACEI or ARB concomitantly who had undergone endoscopic screening for gastric erosion were analyzed for SLCO1B1 polymorphisms by a TaqMan assay.ResultsThe frequency of the SLCO1B1*1b/*1b diplotype (42% vs. 24%; p = 0.002) was significantly higher in the gastric mucosal erosion group than in the control group. After adjustment for significant factors, SLCO1B1*1b/*1b (OR, 2.64; 95% CI, 1.59–4.17; p < 0.05) was found to be associated with gastric mucosal erosion in aspirin users.ConclusionsThe presence of the SLCO1B1*1b/*1b diplotype may be a risk factor for aspirin-induced gastric mucosal erosion in elderly Chinese men taking aspirin and an ACEI or ARB concomitantly.
Highlights
Cardiovascular disease is the leading cause of disability and death in elderly Chinese males
EGFR (55.8 ± 23.1 vs. 70.9 ± 18.5 ml/min/1.73 m2, p > 0.001) and Proton-pump inhibitor (PPI) use (n = 26, 18.2% vs. n = 63, 50.4%, p < 0.001) were lower in the gastric erosion group than in the control group. These baseline clinical factors contributed to aspirin-induced gastric mucosal erosion to a significantly greater extent in the univariate analysis
Factors associated with gastric mucosal erosion After adjusting for significant factors in the univariate analysis, older age, lower estimated glomerular filtration rate (eGFR) level (8.04, 3.02–22.6, p < 0.01), history of gastric ulcer (2.41, 1.08–5.01, p < 0.05), decreased use of a PPI (0.18, 0.11–0.31, p < 0.001) and the solute carrier organic anion transporter 1B1 (SLCO1B1)*1b/ *1b diplotype (2.64, 1.59–4.17, p < 0.05) were significantly associated with gastric mucosal erosion in multiple logistic regression analysis (Table 5)
Summary
Cardiovascular disease is the leading cause of disability and death in elderly Chinese males. Antiplatelet therapy results in a higher incidence of gastrointestinal (GI) injury, gastric mucosal ulcers and hemorrhage [1]. GI injury is related to a poor prognosis of cardiovascular disease [2]. It is well established that long-term use of aspirin may result in gastric mucosal injury but that concomitant use of aspirin and an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II AT-1 receptor. It is well established that long-term use of aspirin can cause gastric mucosal injury. ACEIs and ARBs are inversely related to gastric ulcer development. This study aimed to evaluate the relationship between SLCO1B1 polymorphisms, which can affect ACEI and ARB transport, and gastric mucosal erosion in elderly male Chinese patients with cardiovascular disease who use aspirin
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