ACCF/ACG/AHA 2008 Expert Consensus Document on Reducing the Gastrointestinal Risks of Antiplatelet Therapy and NSAID Use. A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents

Deepak L. Bhatt, James Scheiman, Neena S. Abraham, Elliott M. Antman, Francis K.L. Chan, Curt D. Furberg, David A. Johnson, Kenneth W. Mahaffey, Eamonn M. Quigley, Robert A. Harrington, Eric R. Bates, Charles R. Bridges, Mark J. Eisenberg, Victor A. Ferrari, Mark A. Hlatky, Sanjay Kaul, Jonathan R. Lindner, David J. Moliterno, Debabrata Mukherjee, Richard S. SchofieldRobert S. Rosenson, James H. Stein, Howard H. Weitz, Deborah J. Wesley

Research output: Contribution to journalReview article

372 Scopus citations

Abstract

In appropriate patients oral antiplatelet therapy decreases ischemic risks, but this therapy may increase bleeding complications. Of the major bleeding that occurs, the largest proportion is due to GI hemorrhage. Concomitant use of NSAIDs further raises the risk of GI bleeding. Gastroprotection strategies consist of use of PPIs in patients at high risk of GI bleeding and eradication of H. pylori in patients with a history of ulcers. Communication between cardiologists, gastroenterologists, and primary care physicians is critical to weigh the ischemic and bleeding risks in an individual patient who needs antiplatelet therapy but who is at risk for or develops significant GI bleeding.

Original languageEnglish (US)
Pages (from-to)1502-1517
Number of pages16
JournalJournal of the American College of Cardiology
Volume52
Issue number18
DOIs
StatePublished - Oct 28 2008

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Keywords

  • ACCF Expert Consensus Document
  • NSAID
  • antiplatelet therapy
  • aspirin
  • gastroduodenal ulcer
  • gastrointestinal bleeding
  • gastrointestinal risk
  • stents
  • thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Bhatt, D. L., Scheiman, J., Abraham, N. S., Antman, E. M., Chan, F. K. L., Furberg, C. D., Johnson, D. A., Mahaffey, K. W., Quigley, E. M., Harrington, R. A., Bates, E. R., Bridges, C. R., Eisenberg, M. J., Ferrari, V. A., Hlatky, M. A., Kaul, S., Lindner, J. R., Moliterno, D. J., Mukherjee, D., ... Wesley, D. J. (2008). ACCF/ACG/AHA 2008 Expert Consensus Document on Reducing the Gastrointestinal Risks of Antiplatelet Therapy and NSAID Use. A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Journal of the American College of Cardiology, 52(18), 1502-1517. https://doi.org/10.1016/j.jacc.2008.08.002