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
2011 Impact Factor: 7.282
2011 SCImago Journal Rankings: 0.573
DOIhttp://dx.doi.org/10.1038/ajg.2011.385
ReferencesReferences in Scopus
DC Field
Value
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.
dc.description.natureLink_to_subscribed_fulltext
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.epage396
dc.identifier.hkuros205590
dc.identifier.issn0002-9270
2011 Impact Factor: 7.282
2011 SCImago Journal Rankings: 0.573
dc.identifier.issue3
dc.identifier.pmid22108447
dc.identifier.scopuseid_2-s2.0-84857910372
dc.identifier.spage389
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
Author Affiliations
  1. The University of Hong Kong
  2. Ruttonjee Hospital Hong Kong