Preventing Upper Gastrointestinal Bleeding in Patients with Acute Coronary Syndrome

A proton-pump inhibitor was superior to an H₂-receptor antagonist.

Patients with acute coronary syndrome (ACS) or ST-segment-elevation myocardial infarction (STEMI) are often treated with a combination of antithrombotics plus anticoagulants or thrombolytics. However, these drugs might increase the risk for upper gastrointestinal bleeding (UGIB). The optimal treatment approach to minimize this risk has not been prospectively studied.

Now, investigators in Hong Kong randomized 313 patients hospitalized for ACS or STEMI to receive 20 mg of esomeprazole or 40 mg of famotidine in a double-blind study. Participants were being treated with aspirin, clopidogrel, and enoxaparin or thrombolytics. Patients were followed for occurrence of UGIB.

Follow-up ranged from 4 to 52 weeks, with a mean of 19.0 weeks for the esome…

Reviewing Author

David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)

Disclosures

Nothing to disclose

David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)

Disclosures

Nothing to disclose