Proton pump inhibitors reduce the risk of NSAID associated GI bleeding  in patients taking antithrombotics following an MI, an observational study finds.

Using patient data from all Denmark hospitals over a 14-year period the researchers found that omeprazole, pantoprazole, lanzoprazole and esmoprazole were all associated with a lower risk of bleeding.

The rates of bleeding events per 100 person years for patients on NSAID plus antithrombotic therapy were 1.8 for patients taking PPIs and 2.1 for those not taking PPIs, reported the researchers in the BMJ.

The adjusted risk of bleeding was lower with PPI use (hazard ratio 0.72, 95% CI 0.54 to 0.95) regardless of antithrombotic treatment regimen, type of NSAID, and type of PPI used.

“The results suggest that PPI treatment probably has a beneficial effect regardless of underlying gastrointestinal risk and that when NSAIDs cannot be avoided in post-myocardial infarction patients, physicians might prescribe a PPI as well,” the researchers concluded.