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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2019; 73(4): 319–325. doi:10.14735/amgh2019319.

Does proton pump inhibitors treatment affect the risk of gastrointestinal bleeding in patients on novel antithrombotic therapy?

Ingrid Škorňová1, Tomáš Bolek2, Matej Samoš2, Jakub Marko1, Ľubica Vádelová2, Janka Žolková2, Mária Boleková Lányiová3, Ján Staško1, Marián Mokáň2

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Summary

Oral antithrombotic therapy significantly increases the risk of gastrointestinal bleeding in patients with acute coronary syndromes or atrial fibrillation. Administration of proton pump inhibitors together with antiplatelet and anticoagulant agents may reduce the risk of gastrointestinal bleeding. Several relatively novel antithrombotic agents have been introduced for patients with acute coronary syndromes (clopidogrel, prasugrel, and ticagrelor) or atrial fibrillation requiring long-term anticoagulation therapy (dabigatran, rivaroxaban, apixaban, and edoxaban). These agents might inhibit platelets or coagulation more than older agents; therefore, the need for gastroprotection might be even greater when these new agents are used for long-term antithrombotic therapy. Consequently, these agents are frequently administered together. This review article summarizes recently reported data about the impact of proton pump inhibitors on the risk of novel antithrombotic therapy-associated bleeding.

Keywords

gastrointestinal bleeding, proton pump inhibitors, ADP receptor blocker therapy, novel oral anticoagulants

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