PPI Use with Antithrombotics and NSAIDs Reduces Post-MI Bleeding Risk

Nationwide cohort study findings from Denmark support prophylactic use of PPIs.

The use of proton-pump inhibitors (PPIs) is often recommended to prevent gastrointestinal bleeding (GIB) in patients with cardiac disease who take antithrombotics or nonsteroidal anti-inflammatory drugs (NSAIDs) and are considered at elevated risk for bleeding. Should they be used in all patients who have experienced myocardial infarction (MI)?

To address this question, investigators assessed risk for GIB in a nationwide cohort of 83,000 patients in Denmark who were hospitalized between 1997 and 2011 for a first MI, survived ≥30 days postdischarge, and were administered single or dual antithrombotics. Some also filled one or more prescriptions for NSAIDs (43%) or PPIs (46%) after discharge.

Overall, 3229 GIB episodes occurred (incidence, 0.8 …

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors