Efficacy and safety of pantoprazole sodium versus rabeprazole sodium in prevention of gastrointestinal hemorrhage after percutaneous coronary intervention

Abstract

Objective To explore the short-term efficacy and safety of the proton pump inhibitor(PPI) pantoprazole sodium versus rabeprazole sodium for preventing gastrointestinal hemorrhage after percutaneous coronary intervention(PCI) which used aspirin and clopidogrel dual antiplatelet therapy. Methods The clinical data of patients who were hospitalized in the General Hospital of Shenyang Military Command during February to April 2014 and were diagnosed as coronary heart disease(CHD) and received PCI were collected and analyzed retrospectively. The patients were divided into pantoprazole group(an IV infusion of pantoprazole sodium 40 mg in 0.9% 100 ml sodium chloride,once daily)and rabeprazole group(oral rabeprazole sodium 10 mg once daily). Three days before PCI, the two groups received dual antiplatelet therapy with clopidogrel and aspirin. The occurrence of gastrointestinal hemorrhage and major cardiovascular events and incidence of adverse reactions within two months after PCI were compared. Results A total of 84 patients were enrolled in this study, each group had 42 cases. Pantoprazole sodium group comprised 23 males and 19 females with an average age of (65±8) years; rabeprazole sodium group comprised 22 males and 20 females with an average age of (66±8)years. During follow-up, none of the two groups of patients developed gastrointestinal hemorrhage, no cardiovascular events including myocardial infarction, recurrent angina, stent thrombosis, revascularization occurred. The incidence of gastrointestinal reaction in the pantoprazole sodium group and rabeprazole sodium group were 9.5% (4/42) and 11.9% (5/42), respectively. The results of liver function, kidney function and blood routine tests were within normal range in two groups before and after treatment. Before treatment, pantoprazole sodium group serum aspartate aminotransferase [(47±28)U/L] was higher than that of rabeprazole sodium group [(24±13)U/L], the difference was significant (P=0.020). After treatment, pantoprazole sodium group serum aspartate amino-transferase (28±15) U/L was significantly lower than that before treatment (P=0.026). Conclusions In patients underwent PCI and dual antiplatelet therapy, combined treatment with pantoprazole sodium or rabeprazole sodium may be effective in preventing gastrointestinal hemorrhage and do not increase the risk of cardiovascular events within short time. There was no significant difference in efficacy and safety for preventing gastrointestinal hemorrhage in short-term between intravenous pantoprazole sodium and oral rabeprazole sodium. Key words: Proton pump inhibitors; Pantoprazole; Rabeprazole; Percutaneous coronary intervention; Gastrointestinal hemorrhage