Effects of the short-term application of pantoprazole combined with aspirin and clopidogrel in the treatment of acute STEMI

Abstract

The aim of the present study was to determine the effects of the short-term application of pantoprazole on the co-treatment of acute ST-segment elevation myocardial infarction (STEMI) with aspirin and clopidogrel. A total of 207 acute patients showing primary symptoms of STEMI, who received successful emergent percutaneous coronary intervention treatment during hospitalization were randomly divided into two groups. In the test group proton pump inhibitors (PPIs), the patients were treated with a combination of aspirin and clopidogrel and pantoprazole, while those in the control group were treated only with aspirin and clopidogrel. Gastrointestinal bleeding events and major adverse cardiac events (MACEs) were observed in the two groups. Gastrointestinal bleeding events of the two groups mostly occurred within the first week of hospitalization, although the incidence in the PPIs group was significantly higher than that in the control group (p<0.05). However, no significant difference was observed for the incidence of MACEs between the two groups (p>0.05). In conclusion, the results of the present study have shown that the short-term application of pantoprazole combined with aspirin and clopidogrel does not increase the incidence of MACEs in patients with acute STEMI, reduces the risk of gastrointestinal bleeding, and is thus worth promoting clinically, particularly for high-risk groups.

Influence of proton pump inhibitors on clinical outcomes in coronary heart disease patients receiving aspirin and clopidogrel

“…The baseline characteristics of the patients in the 4 RCTs [ 5 , 6 , 8 , 30 ] and 8 controlled observational studies [ 7 , 9 , 13 , 25 – 29 ] are shown in Table 3 . The study sample sizes ranged from 104 to 8582 patients.…”

“…The mean age of the patients enrolled in the 12 studies ranged from 58 to 69 years, the majority were men, and the majority had hypertension. The proportion of patients with diabetes mellitus ranged from 18% to 39%, but 1 trial [ 6 ] did not report the number of patients with diabetes. The proportion of patients with ACS varied widely; mean follow-up duration ranged from 3.5 to 24 months.…”

“…Seven articles [ 5 , 6 , 8 , 13 , 25 – 27 ] reported cardiogenic death. It occurred in 91 of 7693 patients (1.18%) in the PPI group and 139 of 10,688 patients (1.30%) in the placebo group.…”

“…In some studies, PPIs reduced the occurrence of GI bleeding in patients on DAPT, [ 5 , 6 , 8 ] but other results were contradictory. [ 7 , 13 , 25 , 28 , 29 ] Many studies did not stratify the participants by risk of GI bleeding, with the use of PPIs was determined by clinicians.…”

The relationship between the combined use of various proton pump inhibitors with antiplatelet drugs and the risk of cardiovascular complications

“…Пантопразол. Всего найдено четыре исследования, из них два РКИ [14,38] и два ретроспективных исследования [25,27]. Количество больных в исследованиях варьировало от 207 до 20 596 человек, средний возраст -от 58,5 до 68,6 года.…”