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Nikolsky E et al. – GIB is a serious condition in the scenario of ACS and is independently associated with mortality and ischemic complications.

Exclusive Author Commentary
Dr. Eugenia Nikolsky, 09/23/09

Gastorintestinal bleeding is a rare but very serious condition in the setting of acute coronary syndromes, and is aasociated with high rates of mortality, myocardial infarction and stent thrombosis. Incidence of GIB is increased in elderly, smokers and patients with baseline anemia. Future trials should be directed at assessing measures to prevent GIB in vulnerable populations. According to the randomized FAMOUS trial recently published in the Lancet journal, H2-receptor inhibitor famotidine significantly reduces rates of gastric and duodenal ulcers, and erosive oesophagitis in patients taking low-dose aspirin. This drug therefore may be considered for primary prevention of GIB in patients at risk treated with antiplatelet therapy. Results of randomized COGENT trial will be announced at TCT 2009 this week to show whether combination of clopidogrel plus omeprazole compared to clopidogrel alone is safe and effective in reducing incidence of GIB, in patients treated with aspirin.


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