Effects of gastric medicines on gastroduodenal injury in patients with stable angina during antiplatelet therapy.
BACKGROUND
The aim of this study was to examine the effects of gastric medicines on gastroduodenal injury during antiplatelet therapy after coronary intervention.


METHODS
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.


RESULTS
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.


CONCLUSIONS
Administration of PPI reduced the incidence of gastrointestinal lesions compared with that of the non-PPI group.
Hokimoto
Seiji
S
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan. aogimoto@m.ehime-u.ac.jp
Matsui
Kunihiko
K
Oshima
Shuichi
S
Noda
Katsuo
K
Kaikita
Koichi
K
Sumida
Hitoshi
H
Sugiyama
Seigo
S
Ogawa
Hisao
H
D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy*; D015906:Angioplasty, Balloon, Coronary; D001241:Aspirin / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000187:drug effects*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010437:Peptic Ulcer / Q000139:chemically induced* / Q000517:prevention & control*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D057216:Propensity Score; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D011725:Pyridines / Q000009:adverse effects; D015607:Stents
D006635:Histamine H2 Antagonists; D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors; D011725:Pyridines; C446540:thienopyridine; D001241:Aspirin