Prevalence of Gastric and Small-Intestinal Mucosal Injury in Elderly Patients Taking Enteric-Coated Aspirin by Magnetically Controlled Capsule Endoscopy.

Feng Gao,Jie Zhang,Xue Chen

doi:10.1155/2019/1582590

Abstract

Objective To investigate aspirin-related gastric and small-intestinal mucosal injury in elderly patients by magnetically controlled capsule endoscopy (MCCE). Methods Patients taking enteric-coated aspirin attending the outpatient department of Beijing Anzhen Hospital, Capital Medical University, from September 2017 to July 2019 underwent MCCE to assess injury to the gastric and small-intestinal mucosa. The patients were divided into the elderly group (age ≥ 60 years) and middle-aged group (45 years ≤ age < 60 years), and their clinical data were evaluated. Results Sixty-eight patients (34 per group) taking enteric-coated aspirin were recruited, and the elderly and middle-aged groups did not differ significantly in sex, history of smoking, history of alcohol consumption, body mass index, or accompanying diseases. In the elderly and middle-aged groups, the gastric Lanza scores were 2.0 (2.0, 3.0) and 2.0 (1.0, 3.0; P = 0.192), the numbers of patients with small-intestinal mucosal injuries (at least one erosion and/or ulcer) were 30 (88.2%) and 15 (44.1%; P < 0.001), the numbers of patients with more severe small-intestinal mucosal injuries (larger erosion and/or ulcer) were 11 (32.4%) and 3 (8.8%; P = 0.033), the numbers of patients with ileal erosion were 22 (64.7%) and 8 (23.5%; P = 0.001), and the durations of aspirin use were 30.0 (12.0, 120.0) and 10.5 (2.0–48.0) months (P = 0.007), respectively. Conclusions The rate of small-intestinal mucosal injury was significantly higher in elderly than in middle-aged patients taking enteric-coated aspirin, especially the rate of ileal erosion. MCCE enables the monitoring of aspirin-related gastric and small-intestinal mucosal injury in elderly patients, which can guide treatment decision making.

Highlights

Aspirin inhibits platelet activation and thrombogenesis and is commonly used by patients with cardiovascular diseases [1, 2]
The two groups showed no significant difference in sex; body mass index (BMI); gastric controlled examination time; small-intestinal transit time; or history of digestive ulcer, hypertension, diabetes mellitus, coronary artery disease, atrial fibrillation, cerebral infarction, or hyperlipemia (Table 1)
To further study the effect of the duration of aspirin on the small-intestinal mucosal injury, patients from the elderly group were divided into short period (≤12 months, 10 cases) and long period (>12 months, 24 cases), and the incidences of small-intestinal mucosal injuries were 50.0% and 79.2% (P = 0:089)

Summary

Introduction

Aspirin inhibits platelet activation and thrombogenesis and is commonly used by patients with cardiovascular diseases [1, 2]. It injures the gastrointestinal mucosa by exerting local and systemic effects, leading to erosion, ulceration, and bleeding [3, 4]. The introduction of capsule endoscopy (CE) and double-balloon enteroscopy has increased the rate of detection of aspirinrelated small-intestinal mucosal injury [6,7,8,9]. We investigated aspirin-related gastric and small-intestinal mucosal injury in elderly patients by MCCE

Methods

Results

Conclusion