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Consensus Document Outlines Practical Steps for Reducing Gastrointestinal Risks of Antiplatelet and NSAID Use
Date:10/6/2008

iovascular care.

"Doctors are uncertain about how best to prevent bleeding complications in patients receiving antiplatelet therapy and NSAIDs, which are both commonly used, and can cause erosions in the stomach lining," said Dr. Bhatt. "These recommendations represent the collective expertise of leading cardiologists and gastroenterologists, as well as an extensive review of the literature, and provide specialists with practical measures to manage competing risks and help improve patient safety."

"We must be more proactive in assessing individual patient risk to be able to prevent gastrointestinal problems as antiplatelet therapy is actually initiated," said David A. Johnson, M.D., immediate past president of the American College of Gastroenterology and professor of medicine and chief of gastroenterology at Eastern Virginia Medical School. "Communication among cardiologists, gastroenterologists and primary care physicians is critical. At the same time, patients must tell their doctors about any and all medications they are taking-prescription and over-the-counter medicines-so appropriate measures can be taken to reduce risk."

In fact, according to a recent survey, 18 percent of patients failed to report recent use of non-prescription NSAIDs, which greatly complicates attempts to manage risk. Since GI problems may arise with few, if any, symptoms (e.g., blood in stool, fatigue, abdominal pain), ongoing monitoring is also important.

"The recommendations will help physicians evaluate the risk profile for each patient and either change medications or provide appropriate therapies to help reduce GI complications," said Elliot Anttman, M.D., a member of the writing group and a professor of medicine at Harvard Medical School.

To reduce problems, providers must assess individual patient risk factors for possible GI complications, including age, previous history of ulcers or bleeding, presence of H. pylori (a common bacteria that contribut
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SOURCE American College of Gastroenterology; American College of
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