PPI vs. H2-Blocker to Prevent GI Bleeding Caused by Dual Antiplatelet Therapy

During several months of treatment for acute coronary syndrome, esomeprazole was more effective than famotidine.

Gastrointestinal (GI) bleeding is an important complication when multiple antithrombotic drugs are given to patients with acute coronary syndrome. To compare the efficacy of proton-pump inhibitors (PPIs) and H2-receptor antagonists in such patients, researchers in Hong Kong performed a randomized trial involving 311 participants with acute coronary syndrome requiring aspirin, clopidogrel, and enoxaparin or thrombolytic drugs. Patients received the PPI inhibitor esomeprazole (20 mg daily) or the H2 antagonist famotidine (40 mg daily) orally for a mean of 18 weeks, starting in the hospital. Study participation was terminated when a patient's clopidogrel was stopped.

The primary outcome — endoscopically verified gastroduodenal bleeding, gastric…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose