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Aspirin (acetylsalicylic acid) has a multifactorial effect on the gastric mucosa and leads to gastrointestinal complications including ulcers. As a systemic cyclooxygenase inhibitor, it impairs the gastric mucosal barrier and inhibits platelet aggregation. As a weak acid, it also causes local damage to the gastric mucosa.
To determine if aspirin-induced ulcers are caused by local or systemic effects, investigators in the Netherlands used a national primary care database to retrospectively identify 11,891 patients who were taking aspirin (80 mg) and 7928 who were taking effervescent calcium carbasalate (ECC; 100 mg), a calcium salt of acetylsalicylic acid that does not have the same local effect as aspirin on the gastric mucosa. The incidence…