Comparison of Efficacy Between Pantoprazole and Gefarnate in Treating Upper Gastrointestinal Bleeding Caused by Post-PCI Dual Anti-platelet Therapy / 中国微创外科杂志

ABSTRACT

Objective To investigate the effect of pantoprazole (proton pump inhibitor, PPI) and gefarnate (gastric mucosa protectant) on the prevention of upper gastrointestinal bleeding in patients undergoing post-percutaneous coronary intervention (PCI) dual anti-platelet therapy.Methods This research included 1263 patients taking enteric aspirin and clopidogrel after PCI.The cases were divided into 4 groups routine treatment group (n=332), PPI group (n=318), gastric mucosa protectant group (n=299), and PPI+gastric mucosa protectant group (n=314).A follow-up for 6 months was observed including gastrointestinal symptoms, upper gastrointestinal bleeding, major adverse cardiac events (MACE), and adverse reactions.Results There were 52 cases of upper gastrointestinal bleeding within 6 months, including 21 cases from routine treatment group, 9 from PPI group, 15 from gastric mucosa protectant group, and 7 from PPI+gastric mucosa protectant group.The incidence of upper gastrointestinal bleeding among the 4 groups within 6 months was statistically different (X2=8.883, P=0.031).The routine treatment group had significant higher rate than the PPI group and the gastric mucosa protectant group (P0.05).The upper gastrointestinal bleeding occurred within 3 postoperative months in 34 out of 52 cases (65.4%).There was no statistical significance among the four groups in regard to bleeding occurrence time (X2=4.212,P=0.648).Conclusions Patients undergoing post-PCI dual anti-platelet treatment can reduce the incidence of gastrointestinal bleeding by taking pantoprazole or combined with gefarnate.Intervention against upper gastrointestinal bleeding should start on the first day after PCI and last for a minimum of 3-6 months.