ACCF/ACG/AHA 2008 Expert Consensus Document on Reducing the Gastrointestinal Risks of Antiplatelet Therapy and NSAID Use

Bhatt, Deepak L.; Scheiman, James M.; Abraham, Neena S.; Antman, Elliott M.; Chan, Francis K.L.; Furberg, Curt D.; Johnson, David A.; Mahaffey, Kenneth W.; Quigley, Eamonn Martin

doi:10.1161/circulationaha.108.191087

Cited by 578 publications

(237 citation statements)

References 102 publications

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“…However, as the platelets primarily express COX-1, these drugs do not have anti-thrombotic properties. Based on animal studies, observation of records and clinical trials, it has been proposed that the most important consequences of the selective inhibition of COX-2 in relation to the heart are the propensity to thrombosis, through the shift in the pro-thrombotic/anti-thrombotic balance on the endothelial surface and the loss of the protective effect of the upregulation of COX-2 in myocardial ischemia and myocardial infarction [15][16][17] ( Figure 3). …”

Section: Cardiovascular Effectsmentioning

confidence: 99%

Anti-inflamatórios não esteroides: Efeitos cardiovasculares, cérebro-vasculares e renais

M¹

2010

Arq. Bras. Cardiol.

144

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Section: Cardiovascular Effectsmentioning

confidence: 99%

Anti-inflamatórios não esteroides: Efeitos cardiovasculares, cérebro-vasculares e renais

M¹

2010

Arq. Bras. Cardiol.

144

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“…The number of patients using non-steroidal anti-inflammatory (NSAIDs) and antithrombotic (anticoagulants and antiplatelet) drugs is continuously increasing worldwide, and their gastrointestinal (GI) side effects tend to limit the use [1]. The most important causes of peptic ulcer disease are Helicobacter pylori (H. pylori) infection and NSAIDs treatments, including aspirin in low-doses.…”

Section: Introductionmentioning

confidence: 99%

“…The most important risk factors for GI events are slightly different in low-dose aspirin and in NSAIDs consumers in Western and Asian populations. Previous history of ulcer, concomitant treatment with anticoagulants, advanced age and comorbidities seem to increase the risk for GI complications in NSAIDs consumers, while H. pylori infection, history of ulcer and concurrent gastrotoxic therapies are thought to carry the most important risk for hemorrhage in low-dose aspirin consumers (LDA) [1,5].…”

Section: Introductionmentioning

confidence: 99%

AGT A-20C (rs5050) gene polymorphism and ulcer occurrence in patients treated with low-dose aspirin: a case-control study / Polimorfismul AGT A-20C și ulcerele gastro-duodenale la pacienții sub tratament cu aspirină în doze antiagregante: studiu caz-control

Negovan¹,

Voidăzan²,

Pantea³

et al. 2015

Romanian Review of Laboratory Medicine

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Genetic factors may play a role in prediction of gastrointestinal side effects of aspirin, one of the most used drugs worldwide. We aim to determine a possible correlation between AGT A-20C (rs5050) gene polymorphism and gastro-duodenal ulcer in patients taking low-dose aspirin, adjusted for clinical and histological characteristics.Results. We enrolled 211 patients stratified according to 83 AC and 6 CC patients. There were no significant differences regarding demographical and clinical parameters, except for the frequency of ulcers (4%, 8.4% respective 50%, p=0.03), endoscopic bleeding signs (12.3%, 14.5% respective 50%, p=0.0001) and the frequency of gastritis in biopsy (63.9%, 54.2% respective 16.7%, p=0.03) (OR:9.66, p=0.04) than AA group, as well as variant C allele compared with normal A allele (OR: 2.12, p=0.04). On multivariate analysis, variant homozygous CC genotype p=0.02) for ulcer, while H. pylori infection (OR:2.40, p=0.04) de ulcer (OR:9.66, p=0.04) fața de grupul cu genotip AA, iar alela mutantă C s-a corelat cu un număr mai mare de ulcere decât alela normală A (OR: 2.12, p=0.04). Genotipul homozigot mutant CC pentru polimorfismul p=0.02) pentru apariția ulcerelor, în timp ce infecția cu H. pylori (OR:2.40, p=0.04)

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“…Clopidogrel is an antiplatelet agent used for secondary prevention of cardiovascular disease and, because of the risk of gastrointestinal bleeding, a PPI is recommended when both clopidogrel and aspirin are used as dual antiplatelet therapy. 27 Aspirin may cause gastrointestinal bleeding and the antiplatelet effects of clopidogrel may impair healing of existing gastric erosions and exacerbate gastrointestinal complications. 28 Most drugs (~90%) are metabolized by one of 6 of the 50 CYP450 enzymes-CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP3A4, and CYP3A5, 29 and > 70% are metabolized by CY-P3A4 and CYP2C219.…”

Section: Adverse Interactions With Antiplatelet Therapymentioning

confidence: 99%

Pharmacological and Safety Profile of Dexlansoprazole: A New Proton Pump Inhibitor – Implications for Treatment of Gastroesophageal Reflux Disease in the Asia Pacific Region

Goh

Choi

Hsu

et al. 2016

J Neurogastroenterol Motil

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Although gastroesophageal reflux disease is not as common in Asia as in western countries, the prevalence has increased substantially during the past decade. Gastroesophageal reflux disease is associated with considerable reductions in subjective well-being and work productivity, as well as increased healthcare use. Proton pump inhibitors (PPIs) are currently the most effective treatment for gastroesophageal reflux disease. However, there are limitations associated with these drugs in terms of partial and non-response. Dexlansoprazole is the first PPI with a dual delayed release formulation designed to provide 2 separate releases of medication to extend the duration of effective plasma drug concentration. Dexlansoprazole has been shown to be effective for healing of erosive esophagitis, and to improve subjective well-being by controlling 24-hour symptoms. Dexlansoprazole has also been shown to achieve good plasma concentration regardless of administration with food, providing flexible dosing. Studies in healthy volunteers showed no clinically important effects on exposure to the active metabolite of clopidogrel or clopidogrel-induced platelet inhibition, with no dose adjustment of clopidogrel necessary when coprescribed. This review discusses the role of the new generation PPI, dexlansoprazole, in the treatment of gastroesophageal reflux disease in Asia.

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ACCF/ACG/AHA 2008 Expert Consensus Document on Reducing the Gastrointestinal Risks of Antiplatelet Therapy and NSAID Use

Cited by 578 publications

References 102 publications

Anti-inflamatórios não esteroides: Efeitos cardiovasculares, cérebro-vasculares e renais

Anti-inflamatórios não esteroides: Efeitos cardiovasculares, cérebro-vasculares e renais

AGT A-20C (rs5050) gene polymorphism and ulcer occurrence in patients treated with low-dose aspirin: a case-control study / Polimorfismul AGT A-20C și ulcerele gastro-duodenale la pacienții sub tratament cu aspirină în doze antiagregante: studiu caz-control

Pharmacological and Safety Profile of Dexlansoprazole: A New Proton Pump Inhibitor – Implications for Treatment of Gastroesophageal Reflux Disease in the Asia Pacific Region

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