Treatment and prevention of gastrointestinal bleeding in patients receiving antiplatelet therapy

• 作者: Fumio Itoh Hiroshi Yasuda Hiroyuki Yamamoto Masaki Yamashita Shinya Ishigooka Sun-ichiro Ozawa Yasumasa Matsuo Yoshinori Sato
• 来源期刊: 世界重症医学杂志
• 学科: 医学
• 关键词: ANTIPLATELET therapy ASPIRIN CLOPIDOGREL GASTROINTESTINAL BLEEDING Endoscopy Proton-pump inhibitor
• 年，卷（期）: 2015,（1）
• 页码范围: 40-46
• 页数: 7页
• 分类号: R

摘要

Antiplatelet therapy is the standard of care for the secondary prevention of acute coronary syndrome and ischemic stroke,especially after coronary intervention.However,this therapy is associated with bleeding complications such as gastrointestinal bleeding,which is one of the most common life-threatening complications.Early endoscopy is recommended for most patients with acute upper gastrointestinal bleeding.After successful endoscopic hemostasis,immediate resumption of antiplatelet therapy with proton-pump inhibitors(PPIs)is recommended to prevent further ischemic events.PPI prophylaxis during antiplatelet therapy reduces the risk of upper gastrointestinal bleeding.The potential negative metabolic interaction between PPIs and clopidogrel is still unclear.