BACKGROUND/
AIMS: The
association between
Helicobacter pylori infection and nonsteroidal anti-inflammatory
drugs (
NSAIDs ) or low-
dose aspirin therapy as a
risk factor for
peptic ulcer bleeding (PUB) remains unclear. This study investigated the
risk of PUB associated with H. pylori
infection and
NSAID or low-
dose aspirin therapy in
patients with PUD. MATERIALS AND
METHODS: This
case-control study investigated 340
patients with PUB between 2012 and 2016. The
control group comprised age and
sex -matched
patients with endoscopically documented non-
bleeding ulcers . Using
logistic regression analysis , the adjusted
odds ratio (AOR) was calculated for the
risk of PUB.
RESULTS: Of the
patients investigated, 57.9% in the study group and 51.8% in the
control group were diagnosed with H. pylori
infection (P=0.106).
Logistic regression analysis showed synergistic interaction between H. pylori
infection and low-
dose aspirin therapy .
Multivariate analysis showed that low-
dose aspirin (AOR 3.92, P < 0.001),
NSAIDs (AOR 2.98, P=0.001),
warfarin (AOR 14.57, P=0.011),
gastric ulcer (compared with
duodenal ulcer ) (AOR 1.65, P=0.01), and
smoking (AOR 1.97, P=0.004) increased the
risk of PUB compared with the
risk of PUD.
CONCLUSIONS: Both
NSAIDs and
aspirin are independent
risk factors for
bleeding in
patients with PUD. Additionally, low-
dose aspirin therapy concomitant with H. pylori
infection produced a synergistic effect. Therefore, H. pylori eradication may be crucial in
aspirin users. Moreover, a
proton pump inhibitor should be prescribed in
patients with a
history of
bleeding ulcers who need long-term
NSAID treatment .