CHICAGO — Cardiologists might not be adequately protecting their coronary artery-stenting patients against the risk of upper GI bleeding due to antiplatelet therapy, according to a poster presented at the annual Digestive Disease Week.
The study, led by Steven Chang, M.D., was a chart review of 636 randomly selected patients who received stents at three institutions, including Chicago's Northwestern Memorial Hospital. Most patients received aspirin before (72%) and/or after (97%) stent placement, which increased their risk of peptic ulcer-related bleeding, according to Dr. Chang and his colleagues.
After stenting, however, only 24% were prescribed a proton pump inhibitor (PPI), reported Dr. Chang, who is a consultant to Santarus, a manufacturer of omeprazole.
Three of the stent recipients had a documented history of upper-GI bleeding, 23 had a history of peptic ulcer disease, and 30 were receiving NSAID therapy that was not stopped before stenting. “Few coronary stent patients who are started on aspirin and other antiplatelet agents receive appropriate GI prophylaxis,” Dr. Chang wrote.
But it might not be cost effective to prescribe a PPI to all patients before stent placement, he added. “We recommend that cardiologists give PPIs to patients at risk [of upper GI bleeding] before stenting.”