Why the study?
Gastrointestinal bleeding is a morbid complication of DAPT, prompting evaluation of how contemporary trials ensure appropriate PPI gastroprotection and report its use.
Do contemporary trials of dual antiplatelet therapy after percutaneous coronary intervention include steps to ensure appropriate use of proton pump inhibitor gastroprotection?
Do contemporary trials of dual antiplatelet therapy after percutaneous coronary intervention include steps to ensure appropriate use of proton pump inhibitor gastroprotection?
Major trials of DAPT after PCI consistently overlook protocol guidance and reporting of PPI gastroprotection, highlighting a gap in ensuring patient safety against gastrointestinal bleeding.
DAPT trial safety data may underestimate bleeding without PPI standardization; challenges adequacy of evidence for gastroprotection recommendations.
INTRODUCTION: Gastrointestinal bleeding is a morbid complication of dual antiplatelet therapy (DAPT). We evaluated the extent to which contemporary trials of DAPT included steps to ensure appropriate use of proton pump inhibitor (PPI) gastroprotection and reported rates of PPI use. METHODS: A methodological review of randomized trials comparing varying durations of DAPT after percutaneous coronary intervention. RESULTS: Among 21 trials, none incorporated protocol procedures or guidance for prescribing PPIs. Five reported rates of PPI use (range 25.6-69.1%). DISCUSSION: PPI gastroprotection is overlooked in major trials of DAPT. Appropriate use of PPI gastroprotection represents an important opportunity to improve patient safety.
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Kurlander et al. (2021) studied this question.
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