SAFETY OF ANTITHROMBOTIC THERAPY IN CARDIOLOGICAL PRACTICE: HOW TO PROTECT TUNICA MUCOSA OF GASTROINTESTINAL TRACT?


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Abstract

With long-term antithrombotic therapy in order to prevent gastrointestinal bleeding (GIB) it is essential to ensure adequate protection of the mucous membrane of the gastrointestinal (GI) tract. That is why proton pump inhibitors (PPIs) are usually prescribed, but long-term treatment with these medicines is often accompanied by the development of serious adverse events and is associated with an increased risk of cardiovascular events and death. In addition, they do not protect the intestinal mucosa from the damaging effects of antithrombotic medicines and may even provoke bleeding from the lower part of gastrointestinal tract. Therefore may be more appropriate to use gastroprotective remedies with mechanism of action different from PPIs. Rebamipide (Rebagit), which combines the characteristics of gastro- and enteroprotektor could be referred to that group of medicaments. Numerous studies have proved its effectiveness in gastro and enteropathy associated with the use of antiplatelet agents, including dual antiplatelet therapy. The available evidence base allows rebamipide to be recommended for gastrointestinal mucosa protection and improvement the safety of treatment in patients receiving long-term antithrombotic medicines.

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About the authors

Natalia M. Vorobyeva

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia - economically autonomous structural subdivision «Russian Gerontological Research and Clinical Center»

Email: natalyavorobjeva@mail.ru
Dr. med. habil., head of the Laboratory of cardiovascular aging 129226, Moscow, 16 1st Leonova Str

Olga N. Tkacheva

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia - economically autonomous structural subdivision «Russian Gerontological Research and Clinical Center»

Email: tkacheva@rgnkc.ru
Dr. med. habil., professor, director 129226, Moscow, 16 1st Leonova Str

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