Dual Antiplatelet Therapy and Upper Gastrointestinal Bleeding Risk

Do PPIs Make Any Difference?

Inamul Haq; Fazal-ur-rehman Ali; Shakeel Ahmed; Steven Lindsay; Sudantha Bulugahapitiya


Br J Cardiol. 2013;20(4) 

In This Article

Methods and Materials

The medical records of 177 patients treated with DAT following ACS were specifically reviewed for the study parameters over a 12-month period of time. These patients were consecutive admissions following index myocardial infarction, admitted to the cardiology department of Bradford Teaching Hospital: 66 patients (37.3%) were admitted with ST-elevation myocardial infarction (STEMI) and 111 (62.7%) with non-ST elevation myocardial infarction (NSTEMI). All the patients in the study were given 300 mg aspirin and 300 mg clopidogrel after index myocardial infarction followed by 75 mg aspirin and 75 mg clopidogrel daily. Records of re-admissions with gastrointestinal problems, particularly gastrointestinal bleeding, were retrieved from the medical records department.

Patients were divided in two groups: the PPI group (patients on DAT and PPIs, n=91) and the control group (patients on DAT only, n=86). At the time of data collection, there were no hospital guidelines in terms of prescribing PPIs for these patients. The database was analysed for re-admissions with upper gastrointestinal problems over one year while patients were receiving DAT. The unpaired t-test was used to compare age between the two groups, while Fisher's exact test was used for the remaining demographics, all of which were measured on a categorical scale. Subsequent analysis re-examined the difference adjusting for demographic factors found to significantly vary between groups. These analyses were performed using logistic regression. The end points were re-admissions with gastrointestinal bleeding or death.