García-Rayado Guillermo, Sostres Carlos, Lanas Angel
a Service of Digestive Diseases , University Clinic Hospital Lozano Blesa , Zaragoza , Spain.
b Aragón Health Research Institute (IIS Aragón) , Zaragoza , Spain.
Expert Rev Clin Pharmacol. 2017 Aug;10(8):875-888. doi: 10.1080/17512433.2017.1324782. Epub 2017 Jun 19.
Cardiovascular disease is the most important cause of morbidity and mortality in the world and low-dose aspirin is considered the cornerstone of the cardiovascular disease prevention. However, low-dose aspirin use is associated with gastrointestinal adverse effects in the whole gastrointestinal tract. In this setting, co-therapy with a proton pump inhibitor is the most accepted strategy to reduce aspirin related upper gastrointestinal damage. In addition, some adverse effects have been described with proton pump inhibitors long term use. Areas covered: Low-dose aspirin related beneficial and adverse effects in cardiovascular system and gastrointestinal tract are reviewed. In addition, this manuscript summarizes current data on upper gastrointestinal damage prevention and adverse events with proton pump inhibition. Finally, we discuss the benefit/risk ratio of proton pump inhibitor use in patients at risk of gastrointestinal damage taking low-dose aspirin. Expert commentary: Nowadays, with the current available evidence, the combination of low-dose aspirin with proton pump inhibitor is the most effective therapy for cardiovascular prevention in patients at high gastrointestinal risk. However, further studies are needed to discover new effective strategies with less related adverse events.
心血管疾病是全球发病和死亡的最重要原因，低剂量阿司匹林被认为是心血管疾病预防的基石。然而，使用低剂量阿司匹林会在整个胃肠道产生胃肠道不良反应。在这种情况下，与质子泵抑制剂联合治疗是减少阿司匹林相关上消化道损伤最被认可的策略。此外，长期使用质子泵抑制剂也有一些不良反应被描述。涵盖领域：综述了低剂量阿司匹林在心血管系统和胃肠道的有益和不良影响。此外，本文总结了目前关于预防上消化道损伤和质子泵抑制相关不良事件的数据。最后，我们讨论了在服用低剂量阿司匹林且有胃肠道损伤风险的患者中使用质子泵抑制剂的效益/风险比。专家评论：如今，根据现有证据，低剂量阿司匹林与质子泵抑制剂联合使用是胃肠道高风险患者心血管预防的最有效疗法。然而，需要进一步研究以发现具有较少相关不良事件的新的有效策略。
