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Article: Esomeprazole compared with famotidine in the prevention of upper gastrointestinal bleeding in patients with acute coronary syndrome or myocardial infarction
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TitleEsomeprazole compared with famotidine in the prevention of upper gastrointestinal bleeding in patients with acute coronary syndrome or myocardial infarction
 
AuthorsNg, FH2
Tunggal, P2
Chu, WM2
Lam, KF1
Li, A2
Chan, K2
Lau, YK2
Kng, C2
Keung, KK2
Kwan, A2
Wong, BCY1
 
Issue Date2012
 
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.html
 
CitationAmerican Journal Of Gastroenterology, 2012, v. 107 n. 3, p. 389-396 [How to Cite?]
DOI: http://dx.doi.org/10.1038/ajg.2011.385
 
AbstractObjectives: 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 ratio0.095, 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. © 2012 by the American College of Gastroenterology.
 
ISSN0002-9270
2013 Impact Factor: 9.213
 
DOIhttp://dx.doi.org/10.1038/ajg.2011.385
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorNg, FH
 
dc.contributor.authorTunggal, P
 
dc.contributor.authorChu, WM
 
dc.contributor.authorLam, KF
 
dc.contributor.authorLi, A
 
dc.contributor.authorChan, K
 
dc.contributor.authorLau, YK
 
dc.contributor.authorKng, C
 
dc.contributor.authorKeung, KK
 
dc.contributor.authorKwan, A
 
dc.contributor.authorWong, BCY
 
dc.date.accessioned2012-09-05T05:31:43Z
 
dc.date.available2012-09-05T05:31:43Z
 
dc.date.issued2012
 
dc.description.abstractObjectives: 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 ratio0.095, 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. © 2012 by the American College of Gastroenterology.
 
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dc.identifier.citationAmerican Journal Of Gastroenterology, 2012, v. 107 n. 3, p. 389-396 [How to Cite?]
DOI: http://dx.doi.org/10.1038/ajg.2011.385
 
dc.identifier.doihttp://dx.doi.org/10.1038/ajg.2011.385
 
dc.identifier.eissn1572-0241
 
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dc.identifier.urihttp://hdl.handle.net/10722/163464
 
dc.identifier.volume107
 
dc.languageeng
 
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.html
 
dc.publisher.placeUnited States
 
dc.relation.ispartofAmerican Journal of Gastroenterology
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshAcute Coronary Syndrome - Complications - Drug Therapy
 
dc.subject.meshAged
 
dc.subject.meshAnti-Ulcer Agents - Administration & Dosage - Therapeutic Use
 
dc.subject.meshAspirin - Administration & Dosage - Adverse Effects
 
dc.subject.meshChi-Square Distribution
 
dc.subject.meshDouble-Blind Method
 
dc.subject.meshDrug Therapy, Combination
 
dc.subject.meshEnoxaparin - Administration & Dosage - Adverse Effects
 
dc.subject.meshFamotidine - Administration & Dosage - Therapeutic Use
 
dc.subject.meshFemale
 
dc.subject.meshFibrinolytic Agents - Administration & Dosage - Adverse Effects
 
dc.subject.meshFollow-Up Studies
 
dc.subject.meshGastrointestinal Hemorrhage - Chemically Induced - Prevention & Control
 
dc.subject.meshHumans
 
dc.subject.meshIntestinal Perforation - Etiology - Prevention & Control
 
dc.subject.meshMale
 
dc.subject.meshMiddle Aged
 
dc.subject.meshOmeprazole - Administration & Dosage - Therapeutic Use
 
dc.subject.meshPlatelet Aggregation Inhibitors - Administration & Dosage - Adverse Effects
 
dc.subject.meshProportional Hazards Models
 
dc.subject.meshTiclopidine - Administration & Dosage - Adverse Effects - Analogs & Derivatives
 
dc.subject.meshTreatment Outcome
 
dc.titleEsomeprazole compared with famotidine in the prevention of upper gastrointestinal bleeding in patients with acute coronary syndrome or myocardial infarction
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong
  2. Ruttonjee Hospital Hong Kong