Key preventive approaches to gastrointestinal mucosal injury in cardiological patients

L.O. Minushkina

Central State Medical Academy, Moscow

This paper reviews the aspects of the safety of antithrombotic therapy in cardiological patients. The most common antithrombotic agent used in cardiology is acetylsalicylic acid (ASA). Gastrointestinal (GI) mucosal injury and GI bleedings are relatively common in these individuals. Primary tools to prevent complications, i.e., gastric acid secretion inhibitors and coated ASA, are described. According to current guidelines, proton pump inhibitors (PPIs) are the primary tools to prevent GI tract injury and GI bleedings. In general, PPIs are effective in preventing upper GI tract damage. Therefore, their long-term use is required in cardiological diseases. ASA containing antacid (buffered ASA which dissolves in the stomach) and enteric-coated ASA (which dissolves and is absorbed in the intestinal alkaline environment, thereby affecting drug bioavailability) are prescribed to protect GI mucosa. Pharmacokinetics and pharmacodynamics of  buffered and coated formulations are discussed.

Keywords: acetylsalicylic acid, gastrointestinal bleeding, gastrointestinal mucosa, dyspepsia, antithrombotic therapy, buffered formulations.

For citation: Minushkina L.O. Key preventive approaches to gastrointestinal mucosal injury in cardiological patients. RMJ. 2021;
9:12–16.