Forgerini Marcela, Gini Ana Luísa Rodriguez, Lemos Isabele Held, Santos Ana Caroline Silva, Bessa Maria Paula, Valentini Sandro Roberto, Mastroianni Patrícia de Carvalho
School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, São Paulo, Brazil.
Hosp Pharm. 2024 Dec;59(6):666-676. doi: 10.1177/00185787241269111. Epub 2024 Aug 7.
Upper gastrointestinal bleeding (UGIB) has been identified as a potential adverse drug reaction associated with the use of low-dose aspirin (LDA). This study aimed to investigate the relationship between variants in the gene, which is involved in platelet aggregation, and the risk of UGIB in patients with cardiovascular diseases treated with LDA. A case-control study was conducted at a Brazilian hospital complex. Three groups were defined: (1) case group (n = 50): patients with cardiovascular disease who used LDA and were diagnosed with UGIB of non-variceal etiology, (2) LDA control group (n = 50): patients with cardiovascular disease who used LDA without developing UGIB, and (3) healthy control group (n = 189). Data were collected through face-to-face interviews, and blood samples were collected for the analysis of infection and genotyping of 3 genetic variants [rs2238631 (C > T), rs4807491 (A > G), and rs1131882 (A > G)]. The case group had a significantly higher frequency of carriers of the rs4807491.G allele compared to the control group of LDA users (-value = .004). No significant difference was observed in the proportion of carriers of the rs2238631.T and 1131882.G variants between the studied groups. Carriers of rs2238631.T (OR: 4.515, 95% CI: 1.37-14.89) and rs4807491.G allele (OR: 3.232, 95% CI: 1.12-9.37) exhibited a higher risk of UGIB. These findings suggest that the presence of the rs2238631 and rs4807491 variant alleles is associates with a 3- to 4-fold increased risk of UGIB in patients with cardiovascular diseases treated with LDA. Future studies with larger sample sizes should confirm these results and to better identify individuals who may benefit from chronic LDA use.
上消化道出血（UGIB）已被确定为与使用低剂量阿司匹林（LDA）相关的潜在药物不良反应。本研究旨在调查参与血小板聚集的基因变异与接受LDA治疗的心血管疾病患者发生UGIB的风险之间的关系。在巴西一家综合医院进行了一项病例对照研究。定义了三组：（1）病例组（n = 50）：使用LDA且被诊断为非静脉曲张性病因UGIB的心血管疾病患者；（2）LDA对照组（n = 50）：使用LDA但未发生UGIB的心血管疾病患者；（3）健康对照组（n = 189）。通过面对面访谈收集数据，并采集血样用于分析感染情况以及对3种基因变异[rs2238631（C>T）、rs4807491（A>G）和rs1131882（A>G）]进行基因分型。与LDA使用者对照组相比，病例组中rs4807491.G等位基因携带者的频率显著更高（P值 = 0.004）。在所研究的组之间，rs2238631.T和1131882.G变异携带者的比例未观察到显著差异。rs2238631.T携带者（OR：4.515，95%CI：1.37 - 14.89）和rs4807491.G等位基因携带者（OR：3.232，95%CI：1.12 - 9.37）发生UGIB的风险更高。这些发现表明，rs2238631和rs4807491变异等位基因的存在与接受LDA治疗的心血管疾病患者发生UGIB风险增加3至4倍相关。未来更大样本量的研究应证实这些结果，并更好地识别可能从长期使用LDA中获益的个体。
