thienopyridine and Peptic-Ulcer

Topics: Acute Coronary Syndrome; Aspirin; Clopidogrel; Drug Therapy, Combination; Drug-Eluting Stents; Electrocardiography; Follow-Up Studies; Gastrointestinal Hemorrhage; Humans; Myocardial Infarction; Myocardial Revascularization; Odds Ratio; Peptic Ulcer; Platelet Aggregation Inhibitors; Prognosis; Proton Pump Inhibitors; Pyridines; Randomized Controlled Trials as Topic; Ticlopidine; Time Factors

The aim of this study was to examine the effects of gastric medicines on gastroduodenal injury during antiplatelet therapy after coronary intervention.. A total of 501 patients were enrolled and as dual antiplatelet therapy, aspirin and thienopyridine were administered. Patients were divided into four groups: histamine H2-receptor antagonists (H2RA); proton pump inhibitors (PPI); other gastromucosal protective agents (GMP); or nothing (None), and follow-up lasted 8-20 months.. H2RA were prescribed in 212 cases (42%), PPI in 150 (30%), GMP in 56 (11%), and None in 83 (17%). Significant findings by endoscopy were recognized in 18 cases and upper gastrointestinal bleeding requiring hospitalization occurred in 7 patients (1.4%; H2RA in 4, GMP in 2, and None in 1). There were no gastrointestinal injuries in the PPI group. To minimize the effect of selection bias on gastroduodenal lesions, the propensity score analysis for clinical characteristics was used. The results of propensity score matching showed that administration of PPI reduced the incidence of gastrointestinal lesions compared with that of the non-PPI group.. Administration of PPI reduced the incidence of gastrointestinal lesions compared with that of the non-PPI group.

Topics: Aged; Angina Pectoris; Angioplasty, Balloon, Coronary; Aspirin; Female; Follow-Up Studies; Gastric Mucosa; Gastrointestinal Hemorrhage; Histamine H2 Antagonists; Humans; Male; Peptic Ulcer; Platelet Aggregation Inhibitors; Propensity Score; Proton Pump Inhibitors; Pyridines; Stents