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  • ContentsContents
  • Article InfoArticle Info
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  • Article title
  • Abstract
  • Keywords
  • Introduction
  • Methods
    • Study design and protocol
    • Data sources and search strategy
    • Eligibility criteria
    • Exclusion criteria
    • Study selection
    • Data extraction
    • Risk of Bias assessment
    • Data synthesis
    • Outcomes of interest
  • Pathophysiology of gastrointestinal bleeding in combined anticoagulant and antiplatelet therapy
    • Mechanisms of antiplatelet-induced mucosal injury
    • Anticoagulant-induced hemostatic impairment
    • Synergistic effects of combined therapy
    • Role of gastric acid in bleeding pathogenesis
    • Contribution of Helicobacter pylori infection
    • Lower gastrointestinal bleeding mechanisms
    • Epidemiology of gastrointestinal bleeding in combined antithrombotic therapy
    • Incidence of bleeding events
    • Temporal trends
    • Mortality associated with GI bleeding
    • Healthcare utilization
    • Risk stratification in high-risk populations
    • Patient-related risk factors
    • Advanced age
    • History of gastrointestinal bleeding
    • Comorbid conditions
    • Medication-related risk factors
      • Number of antithrombotic agents
      • Concomitant medications
      • Anticoagulant type
    • Risk assessment tools
    • HAS-BLED Score
    • Other risk models
    • Risk categories
  • Gastroprotective strategies in patients receiving combined anticoagulant and antiplatelet therapy
    • Proton pump inhibitors
    • Mechanisms of gastroprotective effect
    • Clinical effectiveness
    • Selection of specific proton pump inhibitors
    • Duration of therapy
    • Histamine-2 receptor antagonists
      • Comparative effectiveness
    • Helicobacter pylori testing and eradication
    • Mucosal protective agents
    • Non-pharmacologic gastroprotective measu­res
    • Optimization of antithrombotic regimens
    • Management in patients without gastrointestinal bleeding
    • Indications for prophylactic PPI therapy
    • Risk-based approach
    • Acute gastrointestinal bleeding
    • Endoscopic management
    • Pharmacologic therapy
    • Resumption of antithrombotic therapy
    • Secondary prevention
    • Special populations
    • Elderly patients
      • Chronic kidney disease
      • Liver disease
    • Patients with prior gastrointestinal bleeding
    • Patients on triple therapy
    • Adverse effects of gastroprotective therapy
    • Proton pump inhibitors
    • Histamine-2 receptor antagonists
    • Mucosal protective agents
  • Future directions
  • Conclusions
  • Additional information
  • References
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