Analysis of Gastrointestinal Prophylaxis in Patients Receiving Dual Antiplatelet Therapy with Aspirin and Clopidogrel

• DOI: 10.18553/jmcp.2014.20.2.187
• Publication Date: 2016-02-16T18:21:54Z
• Authors: Kathleen M. Morneau; Anne B. Reaves; Julie B. Martin; Carrie S. Oliphant
• Keywords: Gastrointestinal bleeding

Dual antiplatelet therapy (DAPT) has been found to reduce the risk of cardiac death, myocardial infarction, stroke, and stent thrombosis following acute coronary syndrome percutaneous intervention. However, this also shown increase gastrointestinal (GI) bleeding as high 2-fold, especially in patients with multiple factors. Proton pump inhibitor (PPI) decreases risk. The current consensus document on reducing GI risks associated agents no longer recommends PPI for all receiving aspirin (ASA) clopidogrel. recommendation reserves DAPT a history upper or prespecified factors bleeding. To (a) describe use prophylaxis ASA clopidogrel (b) assess incidence adverse outcomes that occurred during readmissions within 6 months index hospitalization. A retrospective chart review between February 1, 2011, October 15, was performed appropriateness based document. Therapy defined appropriate if an indication present prescribed, given. Inappropriate yet received, indicated but incorrect prescribed. Incorrect included prophylaxis, histamine H2 blocker therapy, antacid, combination therapy. During subsequent hospitalizations 6-month period discharge from admission, were assessed development vascular-, GI-, PPI-related events. 250 study evaluated. Gastrointestinal 48% (119/250) patients. Of remaining patients, 56.4% (74/131) met guideline criteria did not receive at discharge, whereas 43.5% (57/131) received when indicated. Thirty-three events identified readmissions, most common type being vascular followed by events, respectively. More than half appropriately. reason nonadherence Vascular could be directly attributed use, despite prophylaxis. Overall, there low related