Document Detail


Gastroprotective Therapy Does Not Improve Outcomes of Patients with Helicobacter pylori -Negative Idiopathic Bleeding Ulcers.
MedLine Citation:
PMID:  22732269     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND & AIMS: We performed a prospective cohort study to investigate the effects of gastroprotective agents (such as such as proton pump inhibitors or histamine-2 receptor antagonists) on long-term clinical outcomes of patients with Helicobacter pylori -negative idiopathic bleeding ulcers. METHODS: Patients with H pylori -negative idiopathic bleeding ulcers were recruited from a single centre, from April 2002 to March 2009 (n=633). Age- and sex-matched patients with H pylori -positive bleeding ulcers were used as controls (n=633). After ulcers had healed, 566 patients in the H pylori -negative idiopathic ulcer cohort received gastroprotective agents, at clinicians' discretion, whereas controls received no gastroprotective agent after H pylori eradication therapy. Patients were followed until September 2011 for endpoints included recurrent ulcer bleeding and all-cause mortality. RESULTS: During the exposed period of 534 person-years, the incidence rates (IRs) of recurrent ulcer bleeding and death were 3.8 (95% confidence interval [CI], 2.6-5.4) and 21.8 (95% CI, 18.8-25.3) per 100 person-years among the patients given gastroprotective agents, compared to IRs of 2.4 (95% CI 1.6-3.5, P =0.08) and 13.8 (95% CI 11.9-16.0, P<0.001) per 100 person-years, respectively, during the unexposed period of 1,588 person-years. Use of gastroprotective agents was not associated with mortality, after adjusting for confounders (hazard ratio 1.1, 95% CI, 0.6-1.7). IRs of recurrent ulcer bleeding and death were significantly higher in patients with H pylori -negative idiopathic ulcers (2.9 and 17.0 per 100 person-years, respectively) than controls (1.1 and 5.9 per 100 person-years; P <0.001). CONCLUSIONS: Gastroprotective agents do not reduce the risk of recurrent bleeding or mortality for patients with H pylori -negative idiopathic bleeding ulcers.
Authors:
Grace Lai-Hung Wong; Kim Wing-Lam Au; Angeline Oi-Shan Lo; Yee-Kit Tse; Jessica Yuet-Ling Ching; Ka-Fai To; Francis Ka-Leung Chan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-22
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  -     ISSN:  1542-7714     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.
Affiliation:
Institute of Digestive Disease, The Chinese University of Hong Kong; Hong Kong SAR, China.
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