THE EROSIVE ULCEROUS LESIONS OF UPPER PART OF GASTROINTESTINAL TRACT IN PATIENTS WITH ISCHEMIC HEART DISEASE: TREATMENT AND PREVENTION


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Abstract

The erosive ulcerous affections of gastrointestinal tract in patients with cardiovascular diseases occur frequently and are conditioned by both ischemia of organs of digestion against the background of reduced cardiac output and intake of low doses of acetylsalicylic acid combined with anti-coagulants. The bleeding can be the first and the only manifestation of gastroduodenal pathology. The treatment and prevention of aspirin-induced gastropathy provides for implementation of eradication of Helicobacter pylori infection, application of cyto-protectors (Misoprostol or Bismuthate tripotassium dicitrate), long-term using of inhibitors of proton pump. Out of them Pantoprazole has a certain advantage at the expense low risk of medicinal interactions, good clinical efficiency and anti-inflammatory effect.

About the authors

Elena V. Luzina

The Chitinskaya state medical academy of Minzdrav of Russia

Email: el.luz@list.ru
candidate of medical sciences, associate professor of the chair of therapy of the faculty of advanced training and professional education of specialists the Chitinskaya state medical academy of Minzdrav of Russia, 672090, Chita, Russian Federation 672090, Chita, Russian Federation

N. V Lareva

The Chitinskaya state medical academy of Minzdrav of Russia

672090, Chita, Russian Federation

A. A Zhilina

The Chitinskaya state medical academy of Minzdrav of Russia

672090, Chita, Russian Federation

E. B Zhigzhitova

The Chitinskaya state medical academy of Minzdrav of Russia

672090, Chita, Russian Federation

E. E Ustinova

The Chitinskaya state medical academy of Minzdrav of Russia

672090, Chita, Russian Federation

References

  1. Верткин А.Л., Фролова Ю.В., Петрик Е.А., Адонина Е.В., Вовк Е.И., Дзивина М.И. Профилактика желудочно-кишечных кровотечений при обострении ишемической болезни сердца. Consilium medicum. Гастроэнтерология. 2008; (2): 3-5
  2. Iwamoto J., Saito Y., Honda A., Matsuzaki Y. Clinical features of gastroduodenal injury associated with long-term low-dose aspirin therapy. World J. Gastroenterol. 2013; 19(11): 1673-82.
  3. Cryer B., Feldman M. Effects of very low dose daily, long-term aspirin therapy on gastric, duodenal, and rectal prostaglandin levels and on mucosal injury in healthy humans. Gastroenterology. 1999; 117(1): 17-25.
  4. Sørensen H.T., Mellemkjaer L., Blot W.J., Nielsen G.L., Steffensen F.H., McLaughlin J.K. et. al. Risk of upper gastrointestinal bleeding associated with use of low-dose aspirin. Am. J. Gastroenterol. 2000; 95(9): 2218-24.
  5. Игнатов Ю.Д., Кукес В.Г., Мазуров В.И., ред. Клиническая фармакология нестероидных противовоспалительных средств. М.: ГЭОТАР-Медиа; 2010
  6. Lanas A., Fuentes J., Benito R., Serrano P., Bajador E., Sáinz R. Helicobacter pylori increases the risk of upper gastrointestinal bleeding in patients taking low-dose aspirin. Aliment. Pharmacol. Ther. 2002; 16(4): 779-86
  7. Рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению инфекции Helicobacter pylori у взрослых. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2012; 22(1): 87-9.
  8. Исаков В.А., ред. Диагностика и лечение инфекции, вызванной Helicobacter pylori: IV Маастрихтское соглашение. Best clinical practice. Русское издание. 2012; (2): 4-23.
  9. Лузина Е.В. Лечение и профилактика эрозивно-язвенных поражений желудка и двенадцатиперстной кишки, вызванных приемом нестероидных противовоспалительных препаратов. Клиническая медицина. 2014; (9): 21-6.
  10. Roth S., Agrawal N., Mahowald M., Montoya H., Robbins D., Miller S. et al. Misoprostol heals gastroduodenal injury in patients with rheumatoid arthritis receiving aspirin. Arch. Intern. Med. 1989; 149(4): 775-9
  11. Каратеев А.Е., Успенский Ю.П., Пахомова И.Г., Насонов Е.Л. Комбинированное лечение язв желудка, индуцированных нестероидными противовоспалительными препаратами. Результаты 4-недельного открытого контролируемого исследования по оценке эффективности комбинации ингибитора протонного насоса и висмута трикалия дицитрата. Терапевтический архив. 2009; (6): 62-7
  12. Hallas J., Dall M., Andries A., Andersen B.S., Aalykke C., Hansen J.M. et al. Use of single and combined antithrombotic therapy and risk of serious upper gastrointestinal bleeding: population based case-control study. BMJ. 2006; 333(7571): 726.
  13. Serbin M.A., Guzauskas G.F., Veenstra D.L. Clopidogrel-Proton Pump Inhibitor Drug-Drug Interaction and Risk of Adverse Clinical Outcomes Among PCI-Treated ACS Patients: A Meta-analysis. J. Manag. Care Spec. Pharm. 2016; 22(8): 939-47.
  14. Drepper M.D., Spahr L., Frossard J.L. Clopidogrel and proton pump inhibitors-where do we stand in 2012? World J. Gastroenterol. 2012; 18(18): 2161-71.
  15. Ивашкин В.Т., Шептулин А.А., Маев И.В., Баранская Е.А., Трухманов А.С., Лапина Т.Л. и др. Клинические рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению язвенной болезни. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2016; 26(6): 40-54
  16. Zvyaga T., Chang S.Y., Chen C., Yang Z., Vuppugalla R., Hurley J. et al. Evaluation of six proton pump inhibitors as inhibitors of various human cytochromes P450: focus on cytochrome P450 2C19. Drug Metab. Dispos. 2012; 40(9): 1698-711.
  17. Macaione F., Montaina C., Evola S., Novo G., Novo S. Impact of dual antiplatelet therapy with proton pump inhibitors on the outcome of patients with acute coronary syndrome undergoing drug-eluting stent implantation. ISRN Cardiol. 2012; 2012: 692-761.
  18. Lee H.J., Han Y.M., Kim E.H., Kim Y.J., Hahm K.B. A possible involvement of Nrf2-mediated heme oxygenase-1 up-regulation in protective effect of the proton pump inhibitor pantoprazole against indomethacin-induced gastric damage in rats. BMC Gastroenterology. 2012; (12): 143.
  19. Ng F.H., Wong S.Y., Lam K.F., Chu W.M., Chan P., Ling Y.H. et al. Famotidine is inferior to pantoprazole in preventing recurrence of aspirin-related peptic ulcers or erosions. Gastroenterology. 2010; 138(1): 82-8.

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