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Low-dose aspirin therapy is widely used for secondary prevention of cardiovascular events, but it increases the risk for gastroduodenal ulcers and related complications. Proton-pump inhibitors (PPIs) decrease rates of ulcers and bleeding in patients taking nonsteroidal anti-inflammatory drugs (NSAIDs) and also reduce the risk for rebleeding in patients taking aspirin (JW Gastroenterol Jan 19 2005). How protective is the PPI esomeprazole in this arena, particularly in older patients?
To find out, investigators conducted a multinational, randomized, double-blind, placebo-controlled trial among 991 patients (age, ≥60) taking low-dose aspirin (75–325 mg/day). Patients were randomized to esomeprazole (20 mg daily) or placebo for 26 weeks. All pat…