Proton pump inhibitors and gastroprotection in patients treated with antithrombotic drugs: A cardiologic point of view

作     者：Maurizio Giuseppe Abrignani Alberto Lombardo Annabella Braschi Nicolo Renda Vincenzo Abrignani 

作者机构：Operative Unit of CardiologyP.Borsellino HospitalASP TrapaniMarsala 91025TrapaniItaly Operative Unit of CardiologyS.Antonio Abate HospitalASP TrapaniErice 91100TrapaniItaly Department of PsychologyEducational Science and Human MovementUniversity of PalermoPalermo 90100Italy Department of DirectionCTA SalusGibellina 91024TrapaniItaly Operative Unit of Internal Medicine with Stroke CareDepartment of Health PromotionMother and Child CareInternal Medicine and Medical Specialties(ProMISE)“G.D’Alessandro”University of PalermoPalermo 90100Italy 

出 版 物：《世界心脏病学杂志:英文版(电子版)》 (World Journal of Cardiology)

年 卷 期：2023年第15卷第8期

页      面：375-394页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Antithrombotic drugs Anticoagulants Aspirin Clopidogrel Gastrointestinal bleeding Proton pump inhibitors 

摘      要：Aspirin,other antiplatelet agents,and anticoagulant drugs are used across a wide spectrum of cardiovascular and cerebrovascular diseases.A concomitant proton pump inhibitor(PPI)treatment is often prescribed in these patients,as gastrointestinal complications are relatively *** the other hand,a potential increased risk of cardiovascular events has been suggested in patients treated with PPIs;in particular,it has been discussed whether these drugs may reduce the cardiovascular protection of clopidogrel,due to pharmacodynamic and pharmacokinetic interactions through hepatic ***,the concomitant use of clopidogrel and omeprazole or esomeprazole has been *** contrast,it remains less known whether PPI use may affect the clinical efficacy of ticagrelor and prasugrel,new P2Y12 receptor *** guidelines recommend PPI use in combination with antiplatelet treatment in patients with risk factors for gastrointestinal bleeding,including advanced age,concurrent use of anticoagulants,steroids,or non-steroidal anti-inflammatory drugs,and Helicobacter pylori(***)*** patients taking oral anticoagulant with risk factors for gastrointestinal bleeding,PPIs could be recommended,even if their usefulness deserves further *** infection should always be investigated and treated in patients with a history of peptic ulcer disease(with or without complication)treated with antithrombotic *** present review summarizes the current knowledge regarding the widespread combined use of platelet inhibitors,anticoagulants,and PPIs,discussing consequent clinical implications.