cardiovascular-agents and Peptic-Ulcer

There are few studies on the association of the risks of upper gastrointestinal (GI) ulcer induced by aspirin combined with other medicines. We investigated the association between peptic ulcer and clinical parameters, including Helicobacter pylori infection and combinations of medicines.. Patients taking 100 mg aspirin for cardiovascular diseases who were planning to undergo endoscopy were enrolled. Serum H. pylori IgG antibody was measured.. A total of 305 patients were enrolled, and 38 patients (12.4%) had ulcer lesions. Sex, smoking, drinking, body mass index, endoscopic findings for gastric atrophy (open type), or presence of H. pylori were not significantly associated with ulcer lesions. Cotreatment with anticoagulants [ticlopidine, 34.2% vs. 21.3%; adjusted odds ratio (OR), 3.1; 95% confidence interval (CI), 1.4-7.1; ticlopidine plus warfarin, 13.2% vs. 3.7%; adjusted OR, 4.4; 95% CI, 1.3-15], proton pump inhibitor (PPI 5.3% vs. 34.8%; adjusted OR, 0.10; 95% CI, 0.02-0.43), and antihypertensive medicine were significantly associated with peptic ulcer. Among antihypertensive medicines, AT1 receptor blocker and angiotensin-converting enzyme (ACE) inhibitor tended to be associated with upper GI ulcer.. PPI was superior to H2-receptor antagonist for prevention of peptic ulcer, and cotreatment with AT1 receptor blocker or ACE inhibitor seemed to reduce peptic ulcer among patients taking low-dose aspirin.

Topics: Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Cardiovascular Agents; Endoscopy; Female; Helicobacter Infections; Helicobacter pylori; Humans; Japan; Male; Middle Aged; Peptic Ulcer; Polypharmacy; Prospective Studies; Risk Factors

Patients with kidney disease and acute myocardial infarction (AMI) receive standard therapy, including thrombolytic medication, less frequently than patients with normal kidney function. Our goal is to identify potential differences in thrombolytic medication delays and thrombolytic-associated bleeding events by severity of kidney disease.. This is a retrospective cohort analysis of Cooperative Cardiovascular Project data for all Medicare patients with AMI from 4,601 hospitals. Outcome measures included time to administration of thrombolytic medication censored at 6 hours and bleeding events.. Of 109,169 patients (mean age, 77.4 years; 50.6% women), 13.9% received thrombolysis therapy. Average time to thrombolytic therapy was longer in patients with worse kidney function. Adjusted hazard ratios for minutes to thrombolytic therapy were 0.83 (95% confidence interval [CI], 0.79 to 0.87) for patients with a serum creatinine level of 1.6 to 2.0 mg/dL (141 to 177 micromol/L) and 0.58 (95% CI, 0.53 to 0.63) for patients with a creatinine level greater than 2.0 mg/dL (>177 micromol/L) or on dialysis therapy compared with those with normal kidney function. Odds ratios for bleeding events in patients administered thrombolytics versus those who were not decreased with worse kidney function: adjusted odds ratios, 2.28 (95% CI, 2.16 to 2.42) in patients with normal kidney function and 1.84 (95% CI, 1.09 to 3.10) in dialysis patients.. Patients with worse kidney function experienced treatment delays, but were not at greater risk for thrombolysis-associated excess bleeding events. Physician concerns of thrombolytic-associated bleeding may not be sufficient reason to delay the administration of thrombolytic medication.

Topics: Aged; Aged, 80 and over; Cardiovascular Agents; Cohort Studies; Comorbidity; Creatinine; Databases, Factual; Diabetes Mellitus; Female; Fibrinolytic Agents; Heart Diseases; Hemorrhage; Humans; Hypertension; Kidney Diseases; Life Tables; Male; Medicare; Myocardial Infarction; Peptic Ulcer; Proportional Hazards Models; Retrospective Studies; Sampling Studies; Thrombolytic Therapy; Time Factors; United States

Topics: Acetylcholine; Cardiovascular Agents; Glycyrrhiza; Histamine; Humans; Muscle Relaxants, Central; Parasympatholytics; Peptic Ulcer

Topics: Antacids; Anti-Ulcer Agents; Cardiovascular Agents; Gastroenteritis; Humans; Muscle Relaxants, Central; Peptic Ulcer

Topics: Antacids; Cardiovascular Agents; Muscle Relaxants, Central; Peptic Ulcer

Topics: Aged; Cardiovascular Agents; Gastrointestinal Diseases; Humans; Muscle Relaxants, Central; Peptic Ulcer

Topics: Cardiovascular Agents; Muscle Relaxants, Central; Peptic Ulcer; Ulcer

Topics: Cardiovascular Agents; Muscle Relaxants, Central; Peptic Ulcer; Piperidines

Topics: Cardiovascular Agents; Muscle Relaxants, Central; Parasympatholytics; Peptic Ulcer

Topics: Anesthetics; Anesthetics, Local; Cardiovascular Agents; Humans; Pain; Peptic Ulcer

Topics: Cardiovascular Agents; Muscle Relaxants, Central; Parasympatholytics; Peptic Ulcer; Recurrence

Topics: Cardiovascular Agents; Communication; Muscle Relaxants, Central; Peptic Ulcer

Topics: Cardiovascular Agents; Muscle Relaxants, Central; Parasympatholytics; Peptic Ulcer

Topics: Cardiovascular Agents; Ergot Alkaloids; Ergotamine; Oxytocics; Peptic Ulcer