Key result
PPI co-therapy linked to ~70% lower GI bleeding risk on antiplatelets without affecting CV events.
Why the study?
Proton pump inhibitors are recommended for gastroprotection during antiplatelet therapy for CAD, but their effect on cardiovascular outcomes remains debated.
Does proton pump inhibitor co-therapy reduce gastrointestinal bleeding without compromising cardiovascular outcomes in patients on antiplatelet therapy for coronary artery disease?
Does proton pump inhibitor co-therapy reduce gastrointestinal bleeding without compromising cardiovascular outcomes in patients on antiplatelet therapy for coronary artery disease?
Proton pump inhibitor co-prescription significantly reduces gastrointestinal bleeding in CAD patients on antiplatelet therapy without increasing the risk of cardiovascular events.
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Supports PPI co-prescription in CAD patients on antiplatelet therapy; reinforces CV safety in real-world cohorts.
Background Coronary artery disease (CAD) management relies on antiplatelet therapy to prevent atherothrombotic events but increases gastrointestinal (GI) bleeding risk. Proton pump inhibitors (PPIs) are recommended for gastroprotection, though their effect on cardiovascular outcomes remains debated. Objectives To evaluate the impact of PPI co-therapy on GI bleeding, cardiovascular events, adverse drug reactions (ADRs), and drug–drug interactions (DDIs) in patients on mono or dual antiplatelet therapy. Methods A prospective observational study was conducted over 4 months in a tertiary care hospital. Patients on mono (MAPT) or dual antiplatelet therapy (DAPT), with or without PPIs, were included. Data on demographics, clinical outcomes, ADRs, and DDIs were analyzed. Results Of 174 patients, 48 received DAPT + PPI, 62 DAPT only, 34 MAPT + PPI, and 30 MAPT only. GI bleeding incidence was lower in PPI groups (DAPT + PPI: 6.25%, MAPT + PPI: 2.9%) versus non-PPI groups (DAPT only: 21%, MAPT only: 13.3%). Cardiovascular outcomes were unaffected (Myocardial Infarction: 27.1% vs 38.7% in DAPT + PPI vs DAPT only). 91 ADRs were reported, mainly GI bleeding (23.1%) and dyspnea (16.5%). Major DDIs included aspirin + clopidogrel (24.8%) and aspirin + ticagrelor (17.3%). Conclusion PPI co-prescription significantly reduced GI bleeding without compromising cardiovascular outcomes, supporting guideline-based prophylaxis in CAD patients receiving antiplatelet therapy.
Reddy et al. (2026) studied this question.
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