虚血性心疾患患者への抗血小板療法としてのアスピリンの投与と消化性潰瘍の発症との関連について

Abstract

Recently, many patients with ischemic heart disease (IHD), including myocardial infarction, angina pectoris, and patients with coronary stent implantation, are receiving chronic aspirin therapy in expectation of its anti-platelet effects. It is well known that, in patients with rheumatic disease on chronic aspirin therapy, aspirin-induced peptic ulcer is frequent and limits its clinical usefulness. In this study, we studied 482 IHD patients after coronary intervention to evaluate the incidence and characteristics of peptic ulcer in patients with IHD. Of these patients, 93% were taking aspirin chronically, and the total incidences of gastric ulcer were 1.8% in male patients and 1.2% in female patients. Among patients with chronic aspirin therapy, elderly patients (≧65 y/o) and patients with past history of peptic ulcer had high incidence of gastric ulcer. The prophylactic anti-ulcer treatment did not affect the occurrence of ulcer. The incidence of gastrointestinal bleeding did not correlate with the type of coronary intervention. Therefore, we should pay careful attention to drug-induced gastric ulcer in elderly patients and patients with past history of peptic ulcer during chronic asprin therapy for IHD.