Prevention of gastrointestinal bleeding in patients receiving oral anticoagulants: focus on proton pump inhibitors
https://doi.org/10.15829/1728-8800-2019-5-128-137
Abstract
The review addresses the issue of the gastrointestinal bleeding (GIB) development in patients receiving oral anticoagulants, and the proton pump inhibitors (PPIs) efficiency in reducing of such complications. Epidemiological data on the prevalence of GIB in the presence of nonwarfarin oral anticoagulants (NOACs) and warfarin intake are presented. The factors that increase the risk of bleeding associated with the use of anticoagulants are discussed, including the potential drug-drug interactions and patients’ dietary habits. A description of the scales that assess the bleeding risks during anticoagulant therapy is given. In the second part of the article the principles of prevention and minimization of the GIB risks in the presence of oral anticoagulants treatment are presented. In the context of evidence-based medicine, the PPIs’ role in reducing the risk of GIB is fully discussed. The results of recent large-scale randomized clinical trials and meta-analyses are described in detail, suggesting the benefits of PPIs in the decreasing the risk of the upper gastrointestinal tract bleeding when NOACs and warfarin are prescribed, especially with concomitant therapy with acetylsalicylic acid. So, PPIs can be considered as one of the effective drug prevention “tools” of these complications.
About the Authors
O. D. Ostroumova
Russian Clinical and Research Center of Gerontology; I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
E. A. Volkova
Moscow State University of Medicine and Dentistry
Russian Federation
Russian Federation
A. I. Kochetkov
Russian Clinical and Research Center of Gerontology
Russian Federation
Russian Federation
Moscow
A. P. Pereverzev
Russian Clinical and Research Center of Gerontology
Russian Federation
Russian Federation
O. N. Tkacheva
Russian Clinical and Research Center of Gerontology
Russian Federation
Russian Federation
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For citations:
Ostroumova O.D., Volkova E.A., Kochetkov A.I., Pereverzev A.P., Tkacheva O.N. Prevention of gastrointestinal bleeding in patients receiving oral anticoagulants: focus on proton pump inhibitors. Cardiovascular Therapy and Prevention. 2019;18(5):128-137. (In Russ.) https://doi.org/10.15829/1728-8800-2019-5-128-137
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