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.
WU Chao, XU Chenying, XU Qingling, TANG Chenyue, YU Lifen
. Optimization of screening potential candidates for use of aspirin as primary prevention in health check-up male subjects aged 50-59 years based on the results of endoscopy[J]. Journal of Diagnostics Concepts & Practice, 2017
, 16(02)
: 171
-177
.
DOI: 10.16150/j.1671-2870.2017.02.010
[1] Bibbins-Domingo K; U.S. Preventive Services Task Force. Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S. Preventive Services Task Force Recommendation Statement[J]. Ann Intern Med,2016,164(12):836-845.
[2] 陈伟伟, 高润霖, 刘力生, 等. 中国心血管病报告-2014年[J]. 中国循环杂志, 2015,30(7):617-622.
[3] 中华医学会消化内镜学分会, 中国抗癌协会肿瘤内镜学专业委员会. 中国早期结直肠癌筛查及内镜诊治指南(2014年, 北京)[J]. 胃肠病学, 2015,20(6):345-365.
[4] 中华消化杂志编委会.消化性溃疡诊断与治疗规范(2016年, 西安)[J]. 中华消化杂志,2016,36(8):508-513.
[5] Yeoh KG, Ho KY, Chiu HM, et al.The Asia-Pacific Co-lorectal Screening score: a validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects[J]. Gut,2011,60(9):1236-1241.
[6] 中华医学会消化病学分会, 中华医学会消化病学分会肿瘤协作组. 中国结直肠癌预防共识意见(2016, 上海)[J]. 中华消化杂志, 2016,21(11):668-686.
[7] Gao QY, Chen HM, Sheng JQ, et al.The first year follow-up after colorectal adenoma polypectomy is important:a multiple-center study in symptomatic hospital-based individuals in China[J]. Frontiers Med,2010,4(4):436-442.
[8] Wong MC, Hirai HW, Luk AK, et al.The knowledge of colorectal cancer symptoms and risk factors among 10,078 screening participants: are high risk individuals more knowledgeable?[J]. PLoS One,2013,8(4):e60366.
[9] Yang XB, Xu QL, Xu CY, et al.Prevalence of colorectal neoplasm in Chinese patients with high-risk coronary artery disease classified by the Asia-Pacific Colorectal Screening score[J]. J Dig Dis,2015,16(2):272-278.
[10] 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会.抗血小板治疗中国专家共识[J]. 中华心血管病杂志,2013,41(3):183-194.
[11] 中华医学会老年医学分会, 《中华内科杂志》编委会, 《中华老年医学杂志》编辑委员会. 阿司匹林在动脉粥样硬化性心血管疾病中的临床应用:中国专家共识(2016)解读[J]. 中华内科杂志,2017,56(1):1-13.
[12] 杨肖波, 俞丽芬, 徐琛莹, 等. 既往胃镜检查对评估经皮冠脉介入术后非急性冠脉综合症患者是否联用质子泵抑制剂的作用[J]. 中华消化内镜杂志,2013,30(3):133-137.
[13] 抗血小板药物消化道损伤的预防和治疗中国专家共识组. 抗血小板药物消化道损伤的预防和治疗中国专家共识(2012年更新版)[J]. 中华内科杂志,2013,52(3):264-270.
