Key result
PPIs reduce upper GI bleeding risk during oral anticoagulation, particularly with concomitant aspirin.
Why the study?
This review addresses the development of gastrointestinal bleeding in patients receiving oral anticoagulants and the efficacy of proton pump inhibitors in reducing these complications.
Do proton pump inhibitors reduce upper gastrointestinal bleeding in patients receiving oral anticoagulants?
Do proton pump inhibitors reduce upper gastrointestinal bleeding in patients receiving oral anticoagulants?
Proton pump inhibitors should be considered an effective strategy for preventing upper gastrointestinal bleeding in patients receiving oral anticoagulants, particularly in high-risk individuals.
The review addresses the issue of the gastrointestinal bleeding (GIB) development in patients receiving oral anticoagulants, and the proton pump inhibitors (PPIs) efficiency in reducing of such complications. Epidemiological data on the prevalence of GIB in the presence of nonwarfarin oral anticoagulants (NOACs) and warfarin intake are presented. The factors that increase the risk of bleeding associated with the use of anticoagulants are discussed, including the potential drug-drug interactions and patients’ dietary habits. A description of the scales that assess the bleeding risks during anticoagulant therapy is given. In the second part of the article the principles of prevention and minimization of the GIB risks in the presence of oral anticoagulants treatment are presented. In the context of evidence-based medicine, the PPIs’ role in reducing the risk of GIB is fully discussed. The results of recent large-scale randomized clinical trials and meta-analyses are described in detail, suggesting the benefits of PPIs in the decreasing the risk of the upper gastrointestinal tract bleeding when NOACs and warfarin are prescribed, especially with concomitant therapy with acetylsalicylic acid. So, PPIs can be considered as one of the effective drug prevention “tools” of these complications.
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Остроумова et al. (2019) conducted a review in Patients receiving oral anticoagulants. Proton pump inhibitors vs. No proton pump inhibitors was evaluated on Upper gastrointestinal tract bleeding. Proton pump inhibitors decrease the risk of upper gastrointestinal tract bleeding when non-warfarin oral anticoagulants or warfarin are prescribed, especially with concomitant acetylsalicylic acid.
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