Date of Award

2025

Document Type

Capstone

Degree Name

Master of Science (MS)

Committee Chair

Trey Boyd

Abstract

Introduction: Coronary heart disease (CHD) is a leading cause of mortality worldwide, with percutaneous coronary intervention (PCI) as the primary therapeutic approach. This review evaluates the effect of proton pump inhibitors (PPIs) on gastrointestinal (GI) bleeding risks and cardiovascular outcomes in patients with CHD who are undergoing PCI.

Methods: A systematic search using the PubMed database was conducted. Included in the search terms were: “dual antiplatelet therapy,” “proton pump inhibitors,” “percutaneous coronary intervention,” and “clopidogrel.” The search was narrowed down to include only systematic reviews, meta-analyses, and randomized control trials (RCTs) that were published in English within the last 10 years. Based on the quality and relevance of the studies, three were selected for final review.

Results: The chosen studies displayed slightly elevated major adverse cardiovascular events (MACE) that were associated with PPI use, while consistently illustrating a substantial decrease in GI bleeding (OR 0.56). Notably, the study on DAPT duration found significantly reduced bleeding risks (OR 0.61) without increased ischemic risks with the use of very short-term DAPT regimens.

Discussion: The evidence suggests PPI use provides a substantial benefit in reducing GI bleeding, despite its associated moderate increase in cardiovascular risks, which further warrants consideration of use in CHD patients who are undergoing PCI. Further research is necessary to improve both gastrointestinal and cardiovascular outcomes in this population.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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