Abstract: Objective: To optimize screening potential candidates for use of aspirin as primary prevention. Methods: Male subjects undergoing endoscopic examination at the endoscopic center of Shanghai Ruijin Hospital were enrolled. According to the endoscopic findings and biopsy result, upper and lower gastrointestinal (GI) lesions were classified. Information of gender, age, race, total cholesterol, HDL-cholesterol, systolic blood pressure, treatment for hypertension, status of diabetes and smoking was collected and 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimation was calculated by the ASCVD Estimator. Results: A total of 5 772 subjects underwent endoscopy under light anesthesia, and 32.7% (1 885) of them were aged 50-59 years, and 839 were male. Endoscopic upper GI mucosal lesions were observed in 33.5% (281/839), and these subjects should be directly excluded because long-term use of aspirin might increase the risk of GI bleeding. One hundred and seven (12.8%) subjects who had high risk of colorectal cancer, 10-year ASCVD risk≥; 10% and had no obvious lesions in upper GI mucosa were the potential candidates for use of aspirin as primary prevention. Among them, 40 male smokers (25.2%) aged 50-59 years with colorectal adenoma or polyps might have better compliance for long-term prophylactic use of aspirin. Conclusions: Endoscopic examination under light anesthesia has optimization effects on screening potential candidates for use of aspirin as primary prevention,with which the risk of GI bleeding induced by long-term use of aspirin might be reduced, and the compliance might be improved because of the understanding of baseline status of GI mucosa.

Key words: Endoscopy, Aspirin, Mucosal injury, Colorectal adenoma, Cardiovascular disease