OMED E-Newsletter Issue 11, 2010: NYSGE Syllabus

Issues in Hemostasis: Antiplatelet Agents and PPIs

By David Greenwald, MD

The New York Society for Gastrointestinal Endoscopy is the largest regional GI endoscopy society in the United States. The Society is dedicated to the teaching and advancement of gastrointestinal endoscopy. The society runs numerous programs throughout the year, including an annual fellow’s endoscopy course each summer, and a major postgraduate endoscopy conference each fall. The next course will be held at the Marriott Marquis in New York during December 15-18, 2010.

Each month a syllabus entry from the 32nd Annual New York Society for Gastrointestinal Endoscopy Course can be accessed here. This month the entry is entitled “Issues in Hemostasis: Antiplatelet Agents and PPIs” by David Greenwald, MD.

Antiplatelet agents, and specifically the thienopyridines such as clopidogrel and ticlopidine, are commonly used to reduce cardiovascular events and often in combination with aspirin. The thienopyridines are antagonists to the platelet cell surface ADP receptor; when this receptor is blocked, subsequent ADP-mediated activation of the GP IIb/IIIa receptor is inhibited. Use of thienopyridines inhibits 40%-60% of ADP-induced platelet aggregation in 3-5 days, and the thienopyridines lead to some antiplatelet activity for 7-10 days. Patients treated with thienopyridines and aspirin are often given PPIs as well to reduce the risk of gastrointestinal bleeding.

» Issues in Hemostasis: Antiplatelet Agents and PPIs (PDF file )