Original ResearchFull Report: Clinical—Alimentary TractEffects of Helicobacter pylori Infection on Long-term Risk of Peptic Ulcer Bleeding in Low-Dose Aspirin Users
Section snippets
Screening of Study Population
Consecutive users of ASA who presented with upper gastrointestinal bleeding to the Endoscopy Centre of the Prince of Wales Hospital were screened for eligibility. The Prince of Wales Hospital serves a local population of 1.5 million people in Hong Kong.
All patients underwent endoscopy within 24 hours of hospitalization to identify the source of bleeding, to secure hemostasis, and to determine their H pylori status. The inclusion criteria were endoscopically confirmed gastroduodenal ulcer
Results
Between May 1995 and January 2000, we screened 499 aspirin users admitted for peptic ulcer bleeding and 2614 cardiovascular patients without a history of ulcer who attended outpatient clinics. Of 499 aspirin users with ulcer bleeding, 15 with indeterminate H pylori status were excluded. A total of 367 patients were enrolled (249 in the H pylori–eradicated cohort and 118 in the H pylori–negative cohort). Of 2614 cardiovascular patients without ulcer history, 537 first-time aspirin users were
Discussion
In this 10-year prospective cohort study, we set out to determine whether testing for H pylori status in ASA users with a high ulcer risk would have an impact on the long-term incidence of ulcer bleeding. All of these ASA users had a history of confirmed ulcer bleeding. They were divided into 2 cohorts, namely, ASA users with H pylori infection at the time of ulcer bleeding who subsequently received eradication therapy (H pylori–eradicated cohort) and ASA users who had no evidence of past or
Acknowledgments
The authors thank the staff of the clinical research team of the Institute of Digestive Disease and the nursing staff of the Endoscopy Center at the Prince of Wales Hospital for their invaluable support.
These results were presented at the Annual Scientific Meeting of the American Gastroenterological Association, Chicago, IL, May 2011.
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Conflicts of interest Francis Chan has served as a consultant to Pfizer, Eisai, Takeda, and Otsuka; he received an independent research grant from Pfizer and has been paid lecture fees (including service on speakers' bureaus) by Pfizer, AstraZeneca, and Takeda; Justin Wu has received grant support from the US National Institutes of Health, and has been paid lecture fees (including service on speakers' bureaus) by AstraZeneca; and Joseph Sung has received consulting fees from the National Health Research Institutes of Taipei and also has been paid lecture fees by AstraZeneca, GSK Pharmaceuticals International, and the American Society for Gastrointestinal Endoscopy. The remaining authors disclose no conflicts.
Funding Supported by the Focused Investments Scheme of The Chinese University of Hong Kong.