Kinetics of HBsAg levels on therapy may help predict HBsAg clearance after treatment. “
“Patients taking antiplatelet agents for the prevention of cardiovascular diseases who develop gastrointestinal bleeding represent a serious challenge in clinical practice. The initial step in reducing gastrointestinal risk of antiplatelet therapy is to assess whether the patient has a continued need for antiplatelet therapy. The next step is to eliminate the GSI-IX risk factors that may place the patient at increased gastrointestinal risk. In the management of bleeding ulcer patients

with high-risk stigmata of recent hemorrhage, resuming antiplatelet agents at 3–5 days after the last dosing is a reasonable strategy. However, patients with low-risk stigmata can keep taking antiplatelet agents immediately following endoscopy. In the management of aspirin-related uncomplicated peptic ulcers

in patients requiring antiplatelet therapies, continuing aspirin plus a powerful proton pump inhibitor is the choice of treatment. Patients who require antiplatelet agents for the prevention of cardiovascular diseases should be tested and treated for Helicobacter pylori infection selleck before starting antiplatelet therapy. Additionally, those with high risks for upper gastrointestinal bleeding should receive co-therapy with a gastroprotective drug, preferably a proton pump inhibitor at standard dose. H2-receptor antagonist can significantly reduce upper gastrointestinal bleeding risk in patients taking low-dose aspirin but it is ineffective

in the prevention of upper gastrointestinal bleeding in clopidogrel users. Although several check details retrospective studies reported that patients prescribed clopidogrel who also took proton pump inhibitors had significant increases in cardiovascular events, the current evidence from a prospective randomized trial does not justify a conclusion that proton pump inhibitors are associated with cardiovascular events among clopidgrel users. Antiplatelet therapy is widely used for cardiovascular (CV) protection. Low-dose aspirin can reduce 20% of stroke, 30% of acute coronary events and 18% of all-cause mortality in the secondary prevention of CV diseases.1 Besides the patients requiring secondary prevention of CV events, the American Heart Association recommends prophylactic aspirin to the subjects who have a 10-year CV risk equal to or more than 10%.2 Currently, approximately 36% of the adult US population—more than 50 million people—is estimated to take aspirin regularly for CV disease prevention.3 Among individuals with known CV diseases, this percentage increases to more than 80%.