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(Circulation. 2008;118:1894-1909.)
© 2008 American Heart Association, Inc.

Expert Consensus Document

ACCF/ACG/AHA 2008 Expert Consensus Document on Reducing the Gastrointestinal Risks of Antiplatelet Therapy and NSAID Use

A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents

Writing Committee Members; Deepak L. Bhatt, MD, FACC, FAHA, Co-Chair; James Scheiman, MD, FACG, Co-Chair^*; Neena S. Abraham, MD, MSCE, FACG^*; Elliott M. Antman, MD, FACC, FAHA; Francis K.L. Chan, MD, FACG^*; Curt D. Furberg, MD, FAHA; David A. Johnson, MD, FACG^*; Kenneth W. Mahaffey, MD, FACC; Eamonn M. Quigley, MD, FACG^*

Key Words: AHA Scientific Statements • gastrointestinal risk • antiplatelet therapy • NSAID • gastroduodenal ulcer • gastrointestinal bleeding • aspirin • stents • thrombosis

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 

Preamble...1895

Introduction...1895

Prevalence of Use—NSAIDs/Aspirin (ASA)...1895

Mechanisms of GI Injury—NSAIDs...1895

Mechanisms of Gastroduodenal

Injury—Clopidogrel...1896

1.    GI Complications of ASA and Non-ASA NSAIDs...1896
   
2.    GI Effects of ASA...1897
   
3.    GI Effects of Combined ASA and Anticoagulant Therapy...1898
   
4.    GI Effects of Clopidogrel...1898
   
5.    GI Effects of Combined Clopidogrel and Anticoagulant Therapy...1899
   
6.    Treatment and Prevention of ASA- and NSAID-Related Gastroduodenal Injury...1899
   
7.    Role of H pylori...1901

         A. Diagnosis of H pylori...1901
   

         B. Tests for Active H pylori...1901
   

         C. Treatment of H pylori...1902
   

   
   
8.    Discontinuation of Antiplatelet Therapy Because of Bleeding...1902
   
9.    Endoscopy in Patients on Mono- or Dual Antiplatelet Therapy...1902
   

Summary...1903

References...1903

Appendix 1...1906

Appendix 2...1908

	Preamble

 
This document has been developed by the American College of Cardiology Foundation (ACCF) Task Force on Clinical Expert Consensus Documents, the American College of Gastroenterology (ACG), and the American Heart Association (AHA). Expert consensus documents (ECDs) are intended to inform practitioners, payers, and other interested parties of the opinion of the ACCF and document cosponsors concerning evolving areas of clinical practice and/or technologies that are widely available or new to the practice community. Topics chosen for coverage by ECDs are so designed because the evidence base, the experience with technology, and/or the clinical practice are not considered sufficiently well developed to be evaluated by the formal American College of Cardiology/American Heart Association (ACC/AHA) practice guidelines process. Often the topic is the subject of ongoing investigation. Thus, the reader should view ECDs as the best attempt of the ACCF and other cosponsors to inform and guide clinical practice in areas where . . . [Full Text of this Article]

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