PMID- 33982954
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20220402
IS  - 1572-0241 (Electronic)
IS  - 0002-9270 (Print)
IS  - 0002-9270 (Linking)
VI  - 116
IP  - 4
DP  - 2021 Apr
TI  - Trials of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention Lack 
      Strategies to Ensure Appropriate Gastroprotection.
PG  - 821-824
LID - 10.14309/ajg.0000000000001134 [doi]
AB  - 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.
FAU - Kurlander, Jacob E
AU  - Kurlander JE
AD  - 1Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, 
      USA; 2VA Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, 
      USA; 3Institute for Healthcare Policy and Innovation, University of Michigan, Ann 
      Arbor, Michigan, USA; 4Department of Internal Medicine, Frankel Cardiovascular 
      Center, University of Michigan, Ann Arbor, Michigan, USA; 5UCLA Health Department 
      of Medicine, Los Angeles, California, USA.
FAU - Barnes, Geoffrey D
AU  - Barnes GD
FAU - Sukul, Devraj
AU  - Sukul D
FAU - Helminski, Danielle
AU  - Helminski D
FAU - Kokaly, Alex N
AU  - Kokaly AN
FAU - Platt, Kevin
AU  - Platt K
FAU - Gurm, Hitinder
AU  - Gurm H
FAU - Saini, Sameer D
AU  - Saini SD
LA  - eng
GR  - K01 HL135392/HL/NHLBI NIH HHS/United States
GR  - K23 DK118179/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Systematic Review
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - *Clinical Trials as Topic
MH  - Dual Anti-Platelet Therapy/*standards
MH  - Humans
MH  - Percutaneous Coronary Intervention/*methods
MH  - Platelet Aggregation Inhibitors/adverse effects/*therapeutic use
MH  - Postoperative Care/*methods
MH  - *Practice Guidelines as Topic
MH  - Stomach/drug effects
MH  - Stomach Diseases/*prevention & control
PMC - PMC8119932
MID - NIHMS1655259
COIS- Disclosures Geoffrey Barnes discloses grant funding from Pfizer/Bristol-Myers 
      Squibb and consulting fees from Pfizer/Bristol-Myers Squibb, Janssen, Portola, 
      and AMAG Pharmaceuticals. Devraj Sukul receives salary support from Blue Cross 
      Blue Shield of Michigan (BCBSM). However, the opinions, beliefs and viewpoints 
      expressed by the authors do not necessarily reflect those of BCBSM or any of its 
      employees. Hitinder Gurm receives research support from Blue Cross and Blue 
      Shield of Michigan, the National Institutes of Health Center for Accelerated 
      Innovations, and Michigan Translational Research and Commercialization for Life 
      Sciences Innovation Hub and is a consultant for Osprey Medical. None of the other 
      authors report any conflicts of interest.
EDAT- 2021/05/14 06:00
MHDA- 2021/06/22 06:00
PMCR- 2022/04/01
CRDT- 2021/05/13 10:14
PHST- 2021/05/13 10:14 [entrez]
PHST- 2021/05/14 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2022/04/01 00:00 [pmc-release]
AID - 00000434-202104000-00037 [pii]
AID - 10.14309/ajg.0000000000001134 [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2021 Apr;116(4):821-824. doi: 10.14309/ajg.0000000000001134.