A multicenter case-control study of the effect of e-nos VNTR polymorphism on upper gastrointestinal hemorrhage in NSAID users

[EN]Bleeding in non-steroidal anti-inflammatory drug (NSAID) users limited their prescription. This first multicenter full case-control study (325 cases and 744 controls), explored the association of e-NOS intron 4 variable number tandem repeat (VNTR) polymorphism with upper gastrointestinal hemorrh...

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Detalles Bibliográficos
Autores: Mallah, Narmeen, Zapata Cachafeiro, Maruxa, Aguirre Gómez, Carmelo, Ibarra García, Eguzkiñe, Palacios Zabalza, Itziar, Macías Garcia, Fernando, Iglesias García, Julio, Piñeiro Lamas, María, Ibáñez, Luisa, Vidal, Xavier, Vendrell, Lourdes, Martín Arias, Luis, Sainz Gil, María, Velasco González, Verónica, Salgado Barreira, Ángel, Figueiras, Adolfo
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad del País Vasco
Repositorio:Addi. Archivo Digital para la Docencia y la Investigación
OAI Identifier:oai:addi.ehu.eus:10810/54122
Acceso en línea:http://hdl.handle.net/10810/54122
Access Level:acceso abierto
Palabra clave:nitric-oxide synthase
nonsteroidal antiinflammatory drugs
low-dose aspirin
hardy-weinberg equilibrium
glycoprotein-ib-alpha
gene polymorphisms
variable number
risk
association
prevention
Descripción
Sumario:[EN]Bleeding in non-steroidal anti-inflammatory drug (NSAID) users limited their prescription. This first multicenter full case-control study (325 cases and 744 controls), explored the association of e-NOS intron 4 variable number tandem repeat (VNTR) polymorphism with upper gastrointestinal hemorrhage (UGIH) in NSAID exposed and unexposed populations and assessed any interaction between this polymorphism and NSAIDs. NSAID users carrying e-NOS intron 4 wild type genotype or VNTR polymorphism have higher odds of UGIH than those unexposed to NSAIDs [Odds Ratio (OR): 6.62 (95% Confidence Interval (CI): 4.24, 10.36) and OR: 5.41 (95% CI 2.62, 11.51), respectively], with no effect modification from VNTR polymorphism-NSAIDs interaction [Relative Excess Risk due to Interaction (RERI): -1.35 (95% CI -5.73, 3.03); Synergism Index (S): 0.77 (95% CI 0.31, 1.94)]. Similar findings were obtained for aspirin exposure. Non-aspirin NSAID users who carry e-NOS intron 4 VNTR polymorphism have lower odds of UGIH [OR: 4.02 (95% CI 1.85, 8.75) than those users with wild type genotype [OR: 6.52 (95% CI 4.09, 10.38)]; though the interaction estimates are not statistically significant [RERI: -2.68 (95% CI -6.67, 1.31); S: 0.53 (95% CI 0.18, 1.55)]. This exploratory study suggests that the odds of UGIH in NSAID or aspirin users does not modify according to patient ' s e-NOS intron 4 genotype.

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