{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T22:40:45Z","timestamp":1776465645976,"version":"3.51.2"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,4,27]],"date-time":"2017-04-27T00:00:00Z","timestamp":1493251200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Aspirin increases the risk of gastrointestinal bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate the risk of lower gastrointestinal bleeding (<jats:styled-content style=\"fixed-case\">LGIB<\/jats:styled-content>) in aspirin users.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Low\u2010dose (75\u2010325\u00a0mg daily) aspirin users and controls matched by age, gender and enrollment time in a 1:5 ratio were selected from 1 million randomly sampled subjects in the National Health Insurance Research Database of Taiwan. Cox proportional hazard regression models were developed to evaluate the predictors of <jats:styled-content style=\"fixed-case\">LGIB<\/jats:styled-content> with adjustments for age, gender, comorbidities including coronary artery disease, ischaemic stroke, diabetes, hypertension, chronic kidney disease, liver cirrhosis, chronic obstructive pulmonary disease, dyslipidemia, uncomplicated peptic ulcer disease, history of peptic ulcer bleeding, and concomitant use of clopidogrel, ticlopidine, warfarin, nonsteroidal anti\u2010inflammatory drugs (<jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>s), cyclooxygenase\u20102 inhibitors, steroids, proton pump inhibitors (<jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content>s), histamine\u20102 receptor antagonists (H2<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>s), nitrates, alendronate, selective serotonin reuptake inhibitors (<jats:styled-content style=\"fixed-case\">SSRI<\/jats:styled-content>s) and calcium channel blockers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 53\u00a0805 aspirin users and 269\u00a0025 controls were included. Aspirin group had a higher incidence of <jats:styled-content style=\"fixed-case\">LGIB<\/jats:styled-content> within 1\u00a0year than control group (0.20% vs 0.06%, <jats:italic>P<\/jats:italic>&lt;.0001). Aspirin (hazard ratio [<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>]: 2.75, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]: 2.06\u20103.65), <jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>s (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>: 8.61, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 3.28\u201022.58), steroids (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>: 10.50, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.98\u201055.57), <jats:styled-content style=\"fixed-case\">SSRI<\/jats:styled-content>s (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>: 11.71, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.40\u201097.94), <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content>s (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>: 8.47, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 2.26\u201031.71), and H2<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>s (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>: 10.83, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 2.98\u201039.33) were significantly associated with <jats:styled-content style=\"fixed-case\">LGIB<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The risk of <jats:styled-content style=\"fixed-case\">LGIB<\/jats:styled-content> was higher in low\u2010dose aspirin users than in aspirin nonusers in this nationwide cohort. Low\u2010dose aspirin, <jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>s, steroids, <jats:styled-content style=\"fixed-case\">SSRI<\/jats:styled-content>s, <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content>s and H2<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>s were independent risk factors for <jats:styled-content style=\"fixed-case\">LGIB<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.14079","type":"journal-article","created":{"date-parts":[[2017,4,27]],"date-time":"2017-04-27T21:31:26Z","timestamp":1493328686000},"page":"1542-1550","source":"Crossref","is-referenced-by-count":55,"title":["The risk of lower gastrointestinal bleeding in low\u2010dose aspirin users"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7572-4201","authenticated-orcid":false,"given":"W.\u2010C.","family":"Chen","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Kaohsiung Veterans General Hospital Kaohsiung Taiwan"},{"name":"School of Medicine National Yang\u2010Ming University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.\u2010H.","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Kaohsiung Veterans General Hospital Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.\u2010T.","family":"Huang","sequence":"additional","affiliation":[{"name":"Center for Medical Informatics and Statistics Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.\u2010J.","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Kaohsiung Veterans General Hospital Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.\u2010C.","family":"Sun","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Kaohsiung Veterans General Hospital Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.\u2010K.","family":"Chuah","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Gastroenterology Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan"},{"name":"College of Medicine Chang Gung University Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.\u2010C.","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Internal Medicine Kaohsiung Medical University Hospital and Kaohsiung Medical University Kaohsiung 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