title: Individualised PPI prescription in patients on combination antiplatelet therapy and upper gastrointestinal events after percutaneous coronary intervention: a cohort study.
abstract: BACKGROUND
  We investigated the effect of individualised proton pump inhibitors (PPI) prescription on upper gastrointestinal adverse events in a cohort of patients who received combination antiplatelet therapy (aspirin and clopidogrel) after percutaneous coronary intervention (PCI).
  
  
  METHODS
  Upper gastrointestinal risk factors and other parameters were extracted from a dedicated electronic database. Patients were contacted with a standardised questionnaire. A structured phone interview was performed in all patients with upper gastrointestinal adverse events.
  
  
  RESULTS
  A cohort of 718 patients on combination therapy yielded 87 (12.1%) patients with prophylactic PPI treatment. Upper gastrointestinal adverse events occurred in 18.4% patients with and in 11.1% patients without prophylactic PPI (OR 1.80, P = 0.054). Co-treatment with corticosteroids was the main identifiable risk factor for upper gastrointestinal adverse events (adjusted OR 5.45, P = 0.014).
  
  
  CONCLUSIONS
  Individualised prescription of PPI-prophylaxis after PCI in patients on combined antiplatelet therapy based on risk assessment for upper gastrointestinal bleeding seems to represent an effective measure to minimise upper gastrointestinal adverse events after PCI.
authors.affiliation: University of Zurich, Zurich, Switzerland. rahel.haeuptle@yahoo.de
authors.forename: Rahel
authors.initials: R
authors.lastname: Häuptle
authors.forename: Daniel
authors.initials: D
authors.lastname: Weilenmann
authors.forename: Tino
authors.initials: T
authors.lastname: Schneider
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Haile
authors.forename: Peter
authors.initials: P
authors.lastname: Ammann
authors.forename: Christina
authors.initials: C
authors.lastname: Knellwolf
authors.forename: Jan
authors.initials: J
authors.lastname: Borovicka
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000628:therapy*; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects; D016907:Adverse Drug Reaction Reporting Systems; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D000077144:Clopidogrel; D015331:Cohort Studies; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D004359:Drug Therapy, Combination; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D010437:Peptic Ulcer / Q000139:chemically induced* / Q000517:prevention & control*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D057285:Precision Medicine; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D000305:Adrenal Cortex Hormones; D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin