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Co-prescription of Dual-Antiplatelet Therapy and Proton Pump Inhibitors: Current Guidelines

Dual-antiplatelet therapy (DAPT) prevents thrombotic complications associated with coronary artery disease, acute coronary syndrome, and stent thrombosis following the percutaneous coronary intervention or coronary artery bypass grafting. When initiating DAPT, the risk of thrombosis must be balanced...

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Detalles Bibliográficos
Autores principales: Saven, Hannah, Zhong, Lynna, McFarlane, Isabel M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8901154/
https://www.ncbi.nlm.nih.gov/pubmed/35273851
http://dx.doi.org/10.7759/cureus.21885
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author Saven, Hannah
Zhong, Lynna
McFarlane, Isabel M
author_facet Saven, Hannah
Zhong, Lynna
McFarlane, Isabel M
author_sort Saven, Hannah
collection PubMed
description Dual-antiplatelet therapy (DAPT) prevents thrombotic complications associated with coronary artery disease, acute coronary syndrome, and stent thrombosis following the percutaneous coronary intervention or coronary artery bypass grafting. When initiating DAPT, the risk of thrombosis must be balanced with the increased risk of upper gastrointestinal bleed (UGIB). Proton-pump inhibitors (PPIs) are concurrently prescribed with DAPT to reduce bleeding risk. In this review, we discuss the benefits and potential complications of DAPT/PPI co-prescription. The only large international randomized control trial (RCT), Clopidogrel and the Optimization of Gastrointestinal Events Trial (COGENT), shows robust evidence that PPIs are a safe and effective method to reduce the risk of bleeding in patients on DAPT. However, more large-scale RCTs are needed to study potential long-term effects and draw a stronger conclusion on this topic.
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spelling pubmed-89011542022-03-09 Co-prescription of Dual-Antiplatelet Therapy and Proton Pump Inhibitors: Current Guidelines Saven, Hannah Zhong, Lynna McFarlane, Isabel M Cureus Cardiology Dual-antiplatelet therapy (DAPT) prevents thrombotic complications associated with coronary artery disease, acute coronary syndrome, and stent thrombosis following the percutaneous coronary intervention or coronary artery bypass grafting. When initiating DAPT, the risk of thrombosis must be balanced with the increased risk of upper gastrointestinal bleed (UGIB). Proton-pump inhibitors (PPIs) are concurrently prescribed with DAPT to reduce bleeding risk. In this review, we discuss the benefits and potential complications of DAPT/PPI co-prescription. The only large international randomized control trial (RCT), Clopidogrel and the Optimization of Gastrointestinal Events Trial (COGENT), shows robust evidence that PPIs are a safe and effective method to reduce the risk of bleeding in patients on DAPT. However, more large-scale RCTs are needed to study potential long-term effects and draw a stronger conclusion on this topic. Cureus 2022-02-03 /pmc/articles/PMC8901154/ /pubmed/35273851 http://dx.doi.org/10.7759/cureus.21885 Text en Copyright © 2022, Saven et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiology
Saven, Hannah
Zhong, Lynna
McFarlane, Isabel M
Co-prescription of Dual-Antiplatelet Therapy and Proton Pump Inhibitors: Current Guidelines
title Co-prescription of Dual-Antiplatelet Therapy and Proton Pump Inhibitors: Current Guidelines
title_full Co-prescription of Dual-Antiplatelet Therapy and Proton Pump Inhibitors: Current Guidelines
title_fullStr Co-prescription of Dual-Antiplatelet Therapy and Proton Pump Inhibitors: Current Guidelines
title_full_unstemmed Co-prescription of Dual-Antiplatelet Therapy and Proton Pump Inhibitors: Current Guidelines
title_short Co-prescription of Dual-Antiplatelet Therapy and Proton Pump Inhibitors: Current Guidelines
title_sort co-prescription of dual-antiplatelet therapy and proton pump inhibitors: current guidelines
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8901154/
https://www.ncbi.nlm.nih.gov/pubmed/35273851
http://dx.doi.org/10.7759/cureus.21885
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