双重抗血小板治疗（DAPT）可预防与冠状动脉疾病相关的血栓性并发症，急性冠脉综合征,经皮冠状动脉介入治疗或冠状动脉旁路移植术后支架内血栓形成。启动DAPT时,血栓形成的风险必须与上消化道出血(UGIB)风险的增加相平衡.质子泵抑制剂（PPIs）与DAPT同时使用以降低出血风险。在这次审查中,我们讨论DAPT/PPI联合处方的益处和潜在并发症.唯一的大型国际随机对照试验（RCT），氯吡格雷与胃肠道事件优化试验（COGENT），显示了强有力的证据表明PPIs是降低DAPT患者出血风险的安全有效方法。然而,需要更大规模的RCT来研究潜在的长期效应,并就此主题得出更有力的结论.
Dual-antiplatelet therapy (DAPT) prevents thrombotic complications associated with coronary artery disease, acute coronary syndrome, and stent thrombosis following the percutaneous coronary intervention or coronary artery bypass grafting. When initiating DAPT, the risk of thrombosis must be balanced with the increased risk of upper gastrointestinal bleed (UGIB). Proton-pump inhibitors (PPIs) are concurrently prescribed with DAPT to reduce bleeding risk. In this review, we discuss the benefits and potential complications of DAPT/PPI co-prescription. The only large international randomized control trial (RCT), Clopidogrel and the Optimization of Gastrointestinal Events Trial (COGENT), shows robust evidence that PPIs are a safe and effective method to reduce the risk of bleeding in patients on DAPT. However, more large-scale RCTs are needed to study potential long-term effects and draw a stronger conclusion on this topic.
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