Letters Primary percutaneous coronary intervention

Gastrointestinal protection with dual antiplatelet therapies

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.j5410 (Published 11 January 2018) Cite this as: BMJ 2018;360:j5410
  1. Ian L P Beales, consultant gastroenterologist
  1. Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
  1. i.beales{at}uea.ac.uk

Dalal and colleagues provide a concise update on the pharmacological and behavioural management of patients after a myocardial infarction.1 This otherwise holistic article does not mention the risks and means of prevention of gastrointestinal bleeding, which is associated with poorer prognosis in this patient population.

Aspirin monotherapy increases the risk of acute gastrointestinal bleeding—overall rates of 0.6-1.0% are probably reasonably accurate2—but recent data have shown that gastrointestinal …

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