Antiplatelet therapy is an essential part of preventive management for patients who are at risk of cardiovascular disease. In most cases, antiplatelet therapy is based on low-dose aspirin, a drug that is very effective in reducing the incidence of cardiovascular disease, but is associated with a significant risk of gastrointestinal toxicity and dyspepsia symptoms that can result from aspirin administration. The purpose of this study is to investigate the prevalence of gastrointestinal complications and symptoms in the long-term use of aspirin in the PERIAN Gilan cohort study (PGCS) population

In this cross-sectional study, about 563 individuals out of 1011 individuals that that take low-dose aspirin (≤325 mg), were included. Demographic data and gastrointestinal symptoms and complications were recorded by a questionair. All analyzes were performed by SPSS version 20 software with a significance level of 0.05

In this study, the mean age of the patients was 62.42 years and 51.2% were females. About 6.7% of participants using NSAID and 11.7% were taking proton pump inhibitors. The average duration of consuming aspirin was 9.59 years and 46% of individuals used aspirin once a week. About 19.7% of participants had dyspepsia and 14.4% had heartburn. No signs of vomiting blood were found in any of the participants. According to the findings, the prevalence of gastrointestinal symptoms in low-dose aspirin users was 27.4%, in which 8.2% had duodenal ulcer, 4.1% had gastric ulcer, 9.1% had duodenal erosion, 17.6% had stomach erosion, 1.8% had acute bleeding, and 74.6% had no gastrointestinal complications. The prevalence of gastrointestinal complications in low-dose aspirin users was 25.4%. The results of multiple logistic regression showed that individuals who use NSAIDs have a higher chance of developing gastrointestinal complications (95% CI: 1.38-6.19, OR=2.93). Also, a long-term use of aspirin (95% CI: 1.02-1.11, OR=1.06) was related to the increase in gastrointestinal symptoms (P=0.005). Gastrointestinal complications were more frequent in individuals with long-term aspirin use (95% CI: 1.02-1.11, OR=1.07) (P=0.005). The results showed that the frequency of gastrointestinal symptoms and complications in low-dose aspirin users with positive endoscopy was significantly higher than that ones with negative endoscopy (P<0.001)

Based on the results of this study, long-term low-dose aspirin is associated with gastrointestinal symptoms and complications. Therefore, it need better clinival management