Jensen BES, et al. - This randomized clinical trial aimed to investigate the impact of screening for risk of upper gastrointestinal bleeding (UGIB) and prophylactic proton pump inhibitor (PPI) treatment in dual-antiplatelet-treated patients at risk of UGIB. Furthermore, the physicians evaluated the significance of dual antiplatelet therapy compliance for cardiovascular events. The clinicians revealed that screening for risk factors for UGIB and subsequent prophylactic PPI treatment did not significantly decrease the rate of UGIB. As per findings, prescription of PPI was correlated with a higher compliance with dual antiplatelet therapy and reduced the risk of recurrent cardiovascular events.

• The clinicians included 2009 patients at the time of first percutaneous coronary intervention in a register-based randomized-controlled trial.
• They randomized them to either screening or control.
• During the 1-year after percutaneous coronary intervention, screened high-risk patients were prescribed pantoprazole 40 mg.

• In screened patients and controls, the incidence of UGIB was 0.8 vs. 1.3%, respectively (P=0.381).
• Compared to controls (8.0%), significantly fewer screened patients (5.4%) underwent upper gastrointestinal endoscopy (P=0.026).
• Compared to controls (4.7%), screened patients (2.9%) had significantly fewer events of unstable angina pectoris (P=0.036) and a higher compliance to dual antiplatelet therapy (88.3 vs. 85.0%) (P=0.035).
• However, the clinicians observed no statistical difference in the incidences of myocardial infarction and all-cause mortality (1.0 vs. 1.5%) (P=0.422).