Evaluation Of Ppi In The Prevention And Treatment Of Upper Gastrointestinal Bleeding Caused By Dual Antiplatelet Therapy After PCI

Objective To evaluate the effect of PPI on prevention and treatment of upper gastrointestinal bleeding caused by double antiplatelet therapy after PCI and its effect on Cardiovascular events.Methods 840 patients with coronary artery disease who first underwent PCI from January 1,2016 to December 31,2016 in the General Hospital of Ningxia Medical University were collected.The patients were divided into the non-PPI group(clopidogrel + aspirin)and the PPI group(PPI was administered orally or intravenously on the basis of the non-PPI group),including 363 in the non-PPI group and 477 in the PPI group,follow up for 1 year,then compare the incidence of upper gastrointestinal bleeding,gastrointestinal discomfort symptoms and Cardiovascular events between the two groups.Retrospective analysis was performed to evaluate the effect of PPI on upper gastrointestinal bleeding caused by double antiplatelet therapy after PCI and its effect on Cardiovascular events.Results1.General information of research populationIn 477 cases of PPI group,the ratio of male to female was 2.10:1,with an average age of63.05 + 10.24 years.In 363 cases of non-PPI group,the ratio of male to female was 2.56:1,with an average age of 60.42 + 10.03 years.There was no significant difference in sex and age between the PPI group and the non-PPI group(P > 0.05).2.Comparison of the incidence of upper gastrointestinal bleeding in the two groupsIn the PPI group,the incidence of upper gastrointestinal bleeding was 1.05%,and the incidence of upper gastrointestinal bleeding in the non-PPI group was 3.03%.The incidence of upper gastrointestinal bleeding in the PPI group was lower than that in the non-PPI group,and the difference was statistically significant(P <0.05).3.Comparison of the incidence of digestive tract discomfort in the two groupsIn the PPI group,the incidence of gastrointestinal discomfort was 3.56%,the incidence of gastrointestinal discomfort in the non-PPI group was 11.57%.The incidence of gastrointestinal discomfort in the PPI group was lower than that in the non-PPI group,and the difference was statistically significant(P <0.05).4.Comparison of the incidence of Cardiovascular events in the two groupsIn the PPI group,the incidence of Cardiovascular events was 7.97%,which was slightly lower than that of the non-PPI group(8.26%),but the difference was not statistically significant(P > 0.05).5.Comparison of incidence of Cardiovascular events in different subgroups of PPI groupAmong the PPI group,there were 365 cases with Pantoprazole,the incidence of Cardiovascular events was 8.22%;74 cases with Lansoprazole,the incidence of Cardiovascular events was 6.76%;7 cases with Esomeprazole,the incidence of Cardiovascular events was 14.29%;5 cases with Omeprazole,the incidence of Cardiovascular events was 40%.The difference was not statistically significant among the subgroups(P >0.05).Conclusion1.The application of PPI can reduce the incidence of gastrointestinal adverse events such as upper gastrointestinal bleeding caused by dual antiplatelet therapy after PCI.2.The combination of PPI with dual antiplatelet after PCI did not increase the incidence of Cardiovascular events in patients.3.There was no significant difference in the effect of different PPI combined with dual antiplatelet therapy on Cardiovascular events after PCI.