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

Abstract 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 he...

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Autores principales:	Narmeen Mallah, Maruxa Zapata-Cachafeiro, Carmelo Aguirre, Eguzkiñe Ibarra-García, Itziar Palacios–Zabalza, Fernando Macías García, Julio iglesias García, María Piñeiro-Lamas, Luisa Ibáñez, Xavier Vidal, Lourdes Vendrell, Luis Martin-Arias, María Sáinz Gil, Verónica Velasco-González, Ángel Salgado-Barreira, Adolfo Figueiras
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/04d8e7980e614588bad2651924b4c258
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spelling	oai:doaj.org-article:04d8e7980e614588bad2651924b4c2582021-12-02T19:16:11ZA multicenter case–control study of the effect of e-nos VNTR polymorphism on upper gastrointestinal hemorrhage in NSAID users10.1038/s41598-021-99402-w2045-2322https://doaj.org/article/04d8e7980e614588bad2651924b4c2582021-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-99402-whttps://doaj.org/toc/2045-2322Abstract 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.Narmeen MallahMaruxa Zapata-CachafeiroCarmelo AguirreEguzkiñe Ibarra-GarcíaItziar Palacios–ZabalzaFernando Macías GarcíaJulio iglesias GarcíaMaría Piñeiro-LamasLuisa IbáñezXavier VidalLourdes VendrellLuis Martin-AriasMaría Sáinz GilVerónica Velasco-GonzálezÁngel Salgado-BarreiraAdolfo FigueirasNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Narmeen Mallah Maruxa Zapata-Cachafeiro Carmelo Aguirre Eguzkiñe Ibarra-García Itziar Palacios–Zabalza Fernando Macías García Julio iglesias García María Piñeiro-Lamas Luisa Ibáñez Xavier Vidal Lourdes Vendrell Luis Martin-Arias María Sáinz Gil Verónica Velasco-González Ángel Salgado-Barreira Adolfo Figueiras A multicenter case–control study of the effect of e-nos VNTR polymorphism on upper gastrointestinal hemorrhage in NSAID users
description	Abstract 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.
format	article
author	Narmeen Mallah Maruxa Zapata-Cachafeiro Carmelo Aguirre Eguzkiñe Ibarra-García Itziar Palacios–Zabalza Fernando Macías García Julio iglesias García María Piñeiro-Lamas Luisa Ibáñez Xavier Vidal Lourdes Vendrell Luis Martin-Arias María Sáinz Gil Verónica Velasco-González Ángel Salgado-Barreira Adolfo Figueiras
author_facet	Narmeen Mallah Maruxa Zapata-Cachafeiro Carmelo Aguirre Eguzkiñe Ibarra-García Itziar Palacios–Zabalza Fernando Macías García Julio iglesias García María Piñeiro-Lamas Luisa Ibáñez Xavier Vidal Lourdes Vendrell Luis Martin-Arias María Sáinz Gil Verónica Velasco-González Ángel Salgado-Barreira Adolfo Figueiras
author_sort	Narmeen Mallah
title	A multicenter case–control study of the effect of e-nos VNTR polymorphism on upper gastrointestinal hemorrhage in NSAID users
title_short	A multicenter case–control study of the effect of e-nos VNTR polymorphism on upper gastrointestinal hemorrhage in NSAID users
title_full	A multicenter case–control study of the effect of e-nos VNTR polymorphism on upper gastrointestinal hemorrhage in NSAID users
title_fullStr	A multicenter case–control study of the effect of e-nos VNTR polymorphism on upper gastrointestinal hemorrhage in NSAID users
title_full_unstemmed	A multicenter case–control study of the effect of e-nos VNTR polymorphism on upper gastrointestinal hemorrhage in NSAID users
title_sort	multicenter case–control study of the effect of e-nos vntr polymorphism on upper gastrointestinal hemorrhage in nsaid users
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/04d8e7980e614588bad2651924b4c258
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A multicenter case–control study of the effect of e-nos VNTR polymorphism on upper gastrointestinal hemorrhage in NSAID users

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