Reducing GI Risks from Antiplatelet and NSAID Therapy

Consensus recommendations for use of gastroprotective therapy in patients who take aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs; including cyclooxygenase inhibitors), or clopidogrel have been released by the American College of Cardiology, the American Heart Association, and the American College of Gastroenterology.

Antiplatelet therapies are associated with well-recognized complications, including gastrointestinal bleeding and ulceration. NSAID-related prostaglandin depletion is responsible for diminished gastroduodenal cytoprotection, decreased renal perfusion, and decreased platelet activity. Symptomatic or complicated ulcers occur in 1 of 20 NSAID users overall and in 1 of 7 users older than 60, with wide variation dependi…