title: Comparison of Intravenous plus Oral Pantoprazole Therapy and Oral Pantoprazole Alone for Preventing Gastrointestinal Bleeding in Acute Coronary Syndrome Patients with High Bleeding Risk.
abstract: BACKGROUND
  It is unclear whether intravenous proton pump inhibition is more effective than oral administration in preventing gastrointestinal (GI) bleeding in high bleeding risk patients with acute coronary syndromes (ACS).
  
  
  RESULTS
  A total of 504 patients with ACS and high bleeding risk were randomly assigned into two groups. Study group (n=252) received intravenous pantoprazole for five days and subsequent oral pantoprazole for 12 months. Control group (n=252) received oral pantoprazole for 12 months. Major adverse cardiac events (death, re-infarction, re-revascularisation and stroke) and GI bleeding were registered after a follow-up of 12 months. No statistically significant differences were found in the major adverse cardiac events between the two groups after the follow-up (p >0.05). The incidence of major GI bleeding in the study group was lower than in the control group (1.2% vs. 3.9%, p=0.049). The bleeding rates in the first 30 days in the study group were also lower than in the control group (0.3% vs. 2.7%, p=0.032).
  
  
  CONCLUSIONS
  The main outcome of cardiac events did not differ between the treatment groups. Intravenous plus oral pantoprazole therapy seemed more effective than oral therapy alone in the prevention of GI bleeding in high bleeding risk patients with ACS.
authors.affiliation: Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Dao-Kuo
authors.initials: DK
authors.lastname: Yao
authors.affiliation: Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Li
authors.affiliation: School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW 2650, Australia. Electronic address: lwang@csu.edu.au.
authors.forename: Le-Xin
authors.initials: LX
authors.lastname: Wang
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage*; D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D061605:Administration, Intravenous; D000284:Administration, Oral; D000368:Aged; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control*; D006801:Humans; D008875:Middle Aged; D000077402:Pantoprazole; D012307:Risk Factors
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000077402:Pantoprazole
keywords: Acute coronary syndrome; Gastrointestinal bleeding; Major adverse cardiac events; Mortality; Pantoprazole