In a combined statement from the AHA, ACC, and ACG, they have recommended expanding use of PPI’s in patients on antiplatelet or NSAID agents at risk for GI bleeding (guidelines). In patients who need an antiplatelet agent, they should be prescribed a PPI if they are at risk for GI bleeding (history of GI bleed or PUD, need for 2 or more antiplatelets, or concomitant anti-coagulation). Additionally, those starting anti-platelet therapy monotherapy with >1 risk factor (age>60, steroids, dyspepsia or GERD ) should also be started on a PPI. Also, in those with a history of PUD, Hyplori testing (and treatment) should be done before starting antiplatelet therapy. All of this is summarized in the following figure (figure)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.