EFFECTS OF NITRATE AND PROPHYLACTIC ASPIRIN ON UPPER GASTROINTESTINAL-BLEEDING - A RETROSPECTIVE CASE-CONTROL STUDY

Experimental studies suggest that nitric-oxide-releasing drugs reduce gastroduodenal damage induced by nonsteroidal anti-inflammatory drugs, but it is not known whether these agents have this effect in humans. The aim of the present study was to evaluate the risk of upper gastroi ntestinal bleeding in patients who receive aspirin and nitrates for va scular occlusive diseases. This was a retrospective case-control study of 736 consecutive patients admitted with upper gastrointestinal blee ding, compared with 1472 age-and sex-matched hospital controls. Chroni c low-dose aspirin regimens had been used by 12.6% of cases and 5.7% o f controls, nitrates by 4.8% and 5.8%, and combined nitrates and low-d ose aspirin by 2.7% and 1.9%, respectively. Logistic regression analys is identified low-dose aspirin use as an independent risk factor for g astrointestinal bleeding, whereas nitrate use was found to be a protec tive factor. The combination of both nitrate and low-dose aspirin was not associated with an increased risk of bleeding.