What does this research mean for the field?

Tegoprazan is associated with lower risks of gastrointestinal bleeding (HR 0.72) and major bleeding (HR 0.69) compared to proton-pump inhibitors in patients with acute myocardial infarction receiving dual antiplatelet therapy after drug-eluting stent implantation. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To assess the safety and effectiveness of tegoprazan compared to proton-pump inhibitors in patients on dual antiplatelet therapy after stent implantation for acute myocardial infarction.

February 8, 2026

Safety and effectiveness of tegoprazan in patients treated with dual antiplatelet therapy after drug-eluting stent implantation for acute myocardial infarction

Key Result

Tegoprazan reduced gastrointestinal bleeding by 28% (HR 0.72) and major bleeding by 31% (HR 0.69) versus PPIs without increasing ischemic events in AMI patients on DAPT.

Key Points

To assess the safety and effectiveness of tegoprazan compared to proton-pump inhibitors in patients on dual antiplatelet therapy after stent implantation for acute myocardial infarction.
Retrospective analysis of claims data from the National Health Insurance Service
Comparison of 2,075 patients using tegoprazan and 19,201 using proton-pump inhibitors
Assessment of gastrointestinal bleeding, major bleeding, myocardial infarction, stroke, and net adverse clinical events over one year.
Tegoprazan associated with lower risk of gastrointestinal bleeding (HR 0.72, P=0.04)
Tegoprazan associated with lower risk of major bleeding (HR 0.69, P=0.04)
Similar risk of myocardial infarction (HR 0.83, P=0.43) and stroke (HR 0.95, P=0.89) between groups
Lower net adverse clinical events (HR 0.75, P=0.03) in the tegoprazan group.

Structured PICO

Does tegoprazan reduce bleeding or ischemic events compared to PPIs in AMI patients receiving DAPT after PCI?

Population

21,276 patients receiving dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for acute myocardial infarction (AMI), mean age 65.2, 75.8% male.

Intervention

Tegoprazan combined with dual antiplatelet therapy (DAPT)

Comparator

Proton-pump inhibitors (PPIs) combined with dual antiplatelet therapy (DAPT)

Outcome

Primary safety outcomes: gastrointestinal bleeding and major bleeding at one year. Primary effectiveness outcomes: myocardial infarction and stroke.safety

In AMI patients on DAPT after PCI, tegoprazan reduces the risk of gastrointestinal and major bleeding compared to PPIs without increasing ischemic events.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Background Data on the interactions between P2Y12 inhibitors and tegoprazan are limited. This study compared the effects of tegoprazan and proton-pump inhibitors (PPIs) on clinical outcomes in patients receiving dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for acute myocardial infarction (AMI). Methods Using the nationwide claims-based databases of the National Health Insurance Service (NHIS) from March 2019 to September 2022, we retrospectively analyzed 21,276 patients treated with either tegoprazan (n = 2,075) or PPIs (n = 19,201) combination with DAPT after PCI for AMI. The primary safety outcomes were gastrointestinal bleeding and major bleeding at one year, while the primary effectiveness outcomes included myocardial infarction and stroke. Net adverse clinical evpents (NACE), defined as composite of major bleeding, myocardial infarction and stroke, were also assessed. Results The mean age was 65.2 ± 12.6 years and 75.8% were male. In a propensity-matched cohort, compared with PPIs, tegoprazan was associated with a lower risk of gastrointestinal bleeding (hazard ratio HR 0.72, 95% confidence interval CI 0.54-0.98, P=0.04) and major bleeding (HR 0.69, 95% CI 0.49-0.98, P=0.04), while the risks of myocardial infarction (HR 0.83, 95% CI 0.53-1.31, P=0.43) and stroke (HR 0.95, 95% CI 0.47-1.94, P=0.89) were similar. NACE was lower in the tegoprazan group (HR 0.75, 95% CI 0.58-0.97, P=0.03). Conclusions the use of tegoprazan was associated with a lower risk of bleeding compared with PPIs, without an increased risk of ischemic events in AMI patients receiving DAPT after PCI. Further prospective studies are warranted.

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