Aspirin and proton-pump inhibitors compared to clopidogrel in patients with history of gastrointestinal bleeding and aspirin consumption

Background: Aspirin is given as secondary prevention in patients with history of cardiovascular or cerebrovascular disease. One of the adverse events of long period aspirin consumption is gastrointestinal bleeding. Usage of aspirin and proton-pump inhibitors combination or clopidogrel as a replacement for aspirin are alternatives which can be used by doctors. But there are differences in opinion among doctors whether a patient should be given aspirin and proton-pump inhibitors combination or replace with clopidogrel. Methods: Literature search was conducted on 3 databases: PubMed®, Cochrane® and Science Direct®. The result of each article was screened based on the title, abstract and full text. Authors chose two Randomized Controlled Trials (RCTs) articles which were considered appropriate. Results: Based on the RCTs found, there is a significant difference clinically and statistically in the administration of aspirin and proton-pump inhibitors combination compared to clopidogrel in reducing the incidence of gastrointestinal bleeding. Conclusions: Combination of aspirin and proton-pump inhibitors have better result compared to clopidogrel to reduce the incidence of gastrointestinal bleeding in patients with a history of gastrointestinal bleeding and aspirin consumption.