Therapeutic Research

Abstract

Background：Bleeding complications in patients undergoing percutaneous coronary intervention（PCI）affect adverse clinical outcomes. Potassium‒competitive acid blocker（P‒CAB）, an anti‒ulcer drug, has theoretical advantages in metabolization or faster acid suppression over proton pump inhibitors（PPIs）for preventing gastrointestinal bleeding（GIB）；however, their differences in clinical outcomes are unclear. Objective：We sought to compare the efficacy of P‒CAB compared with other PPIs after PCI. Methods：A total of 482 consecutive patients undergoing PCI from 2015 to 2016 at a general hospital were initially included. P‒CAB（n＝86, 19％）and PPI（n＝328, 68％） were prescribed to prevent GIB. The primary endpoint was major bleeding defined as Bleeding Academic Research Consortium type 3 to 5 within 30 days after index PCI. The secondary endpoint was major adverse cardiac events（MACEs）including all‒cause death, non‒fatal myocardial infarction, and target vessel/lesion revascularization at 1 year. Results：The baseline characteristics were similar, although there were more male patients in the P‒CAB group（P‒CAB 82.6％［71/86］vs. PPI 67.1％［220/328］, p＝0.005）. Major bleeding and GIB were similar（major bleeding：1.2％［1/86］vs. 2.7％［9/328］, p＝0.70；GIB：0％［0/86］vs. 0.61％［2/328］, p＞0.99）. The incidence of MACE was 8.1％（7/86）in P‒CAB and 15.9％（52/328）in PPI（p＝0.069）；however, Kaplan‒Meier analysis showed that the incidence of MACE was lower in P‒CAB than in PPI among patients treated with second‒generation drug‒eluting stents （log‒rank test, p＝0.02）. Conclusion：P‒CAB and PPIs showed similar effects in preventing bleeding events.