Abstracts from Around the World

Low dose aspirin use for both primary and secondary prevention of vascular disease continues to burgeon. Prior observations suggest that H2 receptor antagonists may be effective in preventing upper gastrointestinal tract mucosal injury. In this randomized double-blind placebo-controlled trial, low dose (75–325 mg/day) aspirin users with vascular disease or diabetes underwent upper endoscopy; if no ulcers or esophagitis was identified, the patients were then randomized to famotidine 20 mg or placebo twice daily. Upper endoscopy was then repeated at 12 weeks with the primary endpoint being development of esophageal, gastric, or duodenal mucosal lesions. Of the patients receiving famotidine, 3.4% developed gastric ulcers, 0.5% developed duodenal ulcers, and 4.4% developed esophagitis; of those receiving placebo, 15% developed gastric ulcers, 8.5% developed duodenal ulcers, and 19% developed esophagitis. Four patients in the placebo group were admitted with gastrointestinal hemorrhage.