Study on effectiveness of gastric acid suppressants in preventing dyspepsia among acute coronary syndrome patients receiving anti-platelet therapy

Introduction: Anti-platelets are commonly used in managing acute coronary syndrome (ACS). Prevalence of dyspepsia among ACS patients receiving anti-platelet therapy was 47.8 % with epigastric pain and heart burn as the most reported symptoms. This study aimed to assess the association of gastric acid suppressor therapy and incidence of dyspepsia among ACS patients receiving anti-platelets in Hospital Melaka.   Methodology:  A cross-sectional study was conducted from October 2017 to June 2019. A total of 298 medical ward patients receiving anti-platelet therapy for ACS were recruited. Patients were interviewed using Leeds Dyspepsia Questionnaire to determine the presence of dyspepsia.   Results:  Two-thirds of study population were on aspirin, 5.7% were on clopidogrel and 29.5 % were on dual anti-platelets (aspirin and clopidogrel). Less than 5.0% of patients on long term anti-platelet therapy reported dyspepsia with heartburn (9.1%) and indigestion (6.7%) as the most troublesome symptoms. 57.1 % of these patients who complained of dyspepsia were prescribed with proton pump inhibitor (PPI) and 28.6 % on H2 receptor antagonist (H2RA). 14.3 % of them were not prescribed with gastric acid suppressant.   Discussion / Conclusion:  This study found that there is significant number of patients taking gastric acid suppressant therapy experiencing dyspepsia (p= 0.004). There was no association between types of anti-platelets and incidence of dyspepsia among ACS patients with or without gastric acid suppressant. Our study shows that gastric acid suppressants are not effective in preventing dyspepsia. This study may serve as a precedent to assist prescriber in prescribing gastric acid suppressant among ACS patients receiving anti-platelet therapy judiciously.  [Disclaimer: Abstract text might vary slightly from what is displayed in the e-poster]