PMID- 22108447
OWN - NLM
STAT- MEDLINE
DCOM- 20120427
LR  - 20181201
IS  - 1572-0241 (Electronic)
IS  - 0002-9270 (Linking)
VI  - 107
IP  - 3
DP  - 2012 Mar
TI  - Esomeprazole compared with famotidine in the prevention of upper gastrointestinal 
      bleeding in patients with acute coronary syndrome or myocardial infarction.
PG  - 389-96
LID - 10.1038/ajg.2011.385 [doi]
AB  - OBJECTIVES: Little is known about the efficacy of proton pump inhibitors compared 
      with H(2) receptor antagonists in preventing adverse upper gastrointestinal 
      complications in patients with acute coronary syndrome (ACS) or ST elevation 
      myocardial infarction (STEMI) receiving aspirin, clopidogrel, and enoxaparin or 
      thrombolytics. The objective of this study was to compare the efficacies of 
      esomeprazole and famotidine in preventing gastrointestinal complications. 
      METHODS: A double-blind, randomized, controlled trial was performed in patients 
      receiving a combination of aspirin, clopidogrel, and either enoxaparin or 
      thrombolytics. Patients received either esomeprazole (20 mg nocte) or famotidine 
      (40 mg nocte) orally for 4-52 weeks, depending on the duration of dual 
      antiplatelet therapy. The primary end point was upper gastrointestinal bleeding 
      (GIB), perforation, or obstruction from ulcer/erosion 
      (http://www.clinicaltrials.gov NCT00683111). RESULTS: In all, 311 patients were 
      recruited, with 163 and 148 patients in the esomeprazole and famotidine groups, 
      respectively. Mean (s.d.) follow-up was 19.2 (17.6) and 17.6 (18.0) weeks, 
      respectively. One (0.6%) patient in the esomeprazole group and 9 (6.1%) in the 
      famotidine group reached the primary end point (log-rank test, P=0.0052, hazard 
      ratio=0.095, 95% confidence interval: 0.005-0.504); all had upper GIB. 
      CONCLUSIONS: In patients with ACS or STEMI, esomeprazole is superior to 
      famotidine in preventing upper gastrointestinal complications related to aspirin, 
      clopidogrel, and enoxaparin or thrombolytics.
FAU - Ng, Fook-Hong
AU  - Ng FH
AD  - Department of Medicine and Geriatric, Ruttonjee Hospital, Hong Kong, China. 
      ngfhong@hkucc.hku.hk
FAU - Tunggal, P
AU  - Tunggal P
FAU - Chu, Wai-Ming
AU  - Chu WM
FAU - Lam, Kwok-Fai
AU  - Lam KF
FAU - Li, Andrew
AU  - Li A
FAU - Chan, Kit
AU  - Chan K
FAU - Lau, Yuk-Kong
AU  - Lau YK
FAU - Kng, Carolyn
AU  - Kng C
FAU - Keung, K K
AU  - Keung KK
FAU - Kwan, Ambrose
AU  - Kwan A
FAU - Wong, Benjamin C Y
AU  - Wong BC
LA  - eng
SI  - ClinicalTrials.gov/NCT00683111
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20111122
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Enoxaparin)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 5QZO15J2Z8 (Famotidine)
RN  - A74586SNO7 (Clopidogrel)
RN  - N3PA6559FT (Esomeprazole)
RN  - OM90ZUW7M1 (Ticlopidine)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Acute Coronary Syndrome/complications/*drug therapy
MH  - Aged
MH  - Anti-Ulcer Agents/administration & dosage/*therapeutic use
MH  - Aspirin/administration & dosage/adverse effects
MH  - Chi-Square Distribution
MH  - Clopidogrel
MH  - Double-Blind Method
MH  - Drug Therapy, Combination
MH  - Enoxaparin/administration & dosage/adverse effects
MH  - Esomeprazole/administration & dosage/*therapeutic use
MH  - Famotidine/administration & dosage/*therapeutic use
MH  - Female
MH  - Fibrinolytic Agents/administration & dosage/*adverse effects
MH  - Follow-Up Studies
MH  - Gastrointestinal Hemorrhage/*chemically induced/*prevention & control
MH  - Humans
MH  - Intestinal Perforation/etiology/prevention & control
MH  - Male
MH  - Middle Aged
MH  - Platelet Aggregation Inhibitors/administration & dosage/*adverse effects
MH  - Proportional Hazards Models
MH  - Ticlopidine/administration & dosage/adverse effects/analogs & derivatives
MH  - Treatment Outcome
EDAT- 2011/11/24 06:00
MHDA- 2012/04/28 06:00
CRDT- 2011/11/24 06:00
PHST- 2011/11/24 06:00 [entrez]
PHST- 2011/11/24 06:00 [pubmed]
PHST- 2012/04/28 06:00 [medline]
AID - ajg2011385 [pii]
AID - 10.1038/ajg.2011.385 [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2012 Mar;107(3):389-96. doi: 10.1038/ajg.2011.385. Epub 2011 
      Nov 22.