PPI Cuts GI Events From Low- and High-dose Aspirin
Key clinical point: In patients at high risk of cardiovascular disease on dual-antiplatelet therapy, concurrent proton pump inhibitor treatment cut gastrointestinal events, regardless of whether patients received a low or high aspirin dosage.
Major finding: Omeprazole cut the rate of upper-GI bleeds by more than half in patients taking low- or high-dose aspirin.
Data source: Post-hoc analysis of data in COGENT, a multicenter, randomized trial with 3,762 patients.
Disclosures: Cogent was sponsored by Cogentus Pharmaceuticals; however, the company went bankrupt and provided no support for the current analysis. Dr. Vaduganathan had no disclosures.
AT ACC 2016
The only caveat Dr. Vaduganathan placed on PPI use was that the COGENT data addressed only 6 months of PPI use; the safety of longer-term use has not been studied. But “the trend is to use PPIs for as short a period as possible,” and the risk for adverse effects from PPI treatment on cardiovascular disease events is likely greatest during the first 6 months of PPI treatment, he noted. If PPI treatment needs to continue beyond 6 months, he suggested systematically reassessing the risk-benefit balance for individual patients from continued PPI treatment every 3 months.
