PMID- 28363584
OWN - NLM
STAT- MEDLINE
DCOM- 20170615
LR  - 20220311
IS  - 1535-6280 (Electronic)
IS  - 0146-2806 (Linking)
VI  - 42
IP  - 5
DP  - 2017 May
TI  - Upper Gastrointestinal Toxicity Associated With Long-Term Aspirin Therapy: 
      Consequences and Prevention.
PG  - 146-164
LID - S0146-2806(17)30016-6 [pii]
LID - 10.1016/j.cpcardiol.2017.01.006 [doi]
AB  - Antiplatelet therapy represents a fundamental part of preventive management for 
      patients who are at risk of a secondary cardiovascular disease (CVD) event. In 
      most cases, the antiplatelet regimen is based on low-dose aspirin, a drug that is 
      highly effective in reducing the incidence of CVD events, but is associated with 
      a substantial risk of gastrointestinal (GI) toxicity. The dyspeptic symptoms, 
      which can result from aspirin administration, and which may occur with or without 
      associated ulceration and bleeding, may lead patients to discontinue therapy, 
      thus increasing their CVD risk. For patients in whom aspirin is indicated and who 
      are deemed to be at increased risk of upper GI events, concomitant therapy with a 
      proton pump inhibitor (PPI) is currently recommended. These agents are highly 
      effective in reducing the upper GI lesions associated with aspirin therapy and 
      have been associated with increased aspirin adherence. However, widespread 
      under-prescribing of PPIs and potential noncompliance with their use means that 
      substantial numbers of patients are at unnecessary risk of upper GI toxicity 
      and-if aspirin therapy is discontinued-CVD events. Provision of aspirin and an 
      immediate-release PPI as a coordinated-delivery combination tablet has been shown 
      to both reduce the risk of gastric ulcer formation and improve patient 
      compliance. This strategy, which may ultimately reduce the incidence of CVD 
      outcomes because of the associated reduction in GI symptoms and the potential for 
      greater patient adherence to aspirin, warrants further investigation under both 
      randomized controlled conditions (explanatory trials), and in real-life settings 
      (pragmatic trials).
CI  - Copyright (c) 2017 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Lavie, Carl J
AU  - Lavie CJ
FAU - Howden, Colin W
AU  - Howden CW
FAU - Scheiman, James
AU  - Scheiman J
FAU - Tursi, James
AU  - Tursi J
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20170201
PL  - Netherlands
TA  - Curr Probl Cardiol
JT  - Current problems in cardiology
JID - 7701802
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Aspirin/*adverse effects/therapeutic use
MH  - Cardiovascular Diseases/*drug therapy
MH  - Gastrointestinal Diseases/*chemically induced/epidemiology
MH  - Gastrointestinal Tract/*drug effects
MH  - Global Health
MH  - Humans
MH  - Incidence
MH  - Intestinal Mucosa/drug effects
MH  - Platelet Aggregation Inhibitors/adverse effects/therapeutic use
MH  - Risk Factors
MH  - Time Factors
EDAT- 2017/04/02 06:00
MHDA- 2017/06/16 06:00
CRDT- 2017/04/02 06:00
PHST- 2017/04/02 06:00 [entrez]
PHST- 2017/04/02 06:00 [pubmed]
PHST- 2017/06/16 06:00 [medline]
AID - S0146-2806(17)30016-6 [pii]
AID - 10.1016/j.cpcardiol.2017.01.006 [doi]
PST - ppublish
SO  - Curr Probl Cardiol. 2017 May;42(5):146-164. doi: 10.1016/j.cpcardiol.2017.01.006. 
      Epub 2017 Feb 1.