Yasuda H, Matsuo Y, Sato Y, Ozawa SI, Ishigooka S, Yamashita M, Yamamoto H, Itoh F. Treatment and prevention of gastrointestinal bleeding in patients receiving antiplatelet therapy.
World J Crit Care Med 2015;
4:40-46. [PMID:
25685721 PMCID:
PMC4326762 DOI:
10.5492/wjccm.v4.i1.40]
[Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 12/26/2014] [Accepted: 01/19/2015] [Indexed: 02/06/2023] Open
Abstract
Antiplatelet therapy is the standard of care for the secondary prevention of acute coronary syndrome and ischemic stroke, especially after coronary intervention. However, this therapy is associated with bleeding complications such as gastrointestinal bleeding, which is one of the most common life-threatening complications. Early endoscopy is recommended for most patients with acute upper gastrointestinal bleeding. After successful endoscopic hemostasis, immediate resumption of antiplatelet therapy with proton-pump inhibitors (PPIs) is recommended to prevent further ischemic events. PPI prophylaxis during antiplatelet therapy reduces the risk of upper gastrointestinal bleeding. The potential negative metabolic interaction between PPIs and clopidogrel is still unclear.
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