Intravenous Pantoloc In Aspirin-Induced Ulcer Bleeding

• Primary Outcome:
• Recurrent upper gastrointestinal bleeding within 30 days

The aim of the study is to investigate whether intravenous infusion of pantoprazole (Pantoloc) is effective in preventing recurrent bleeding in patients who present with acute ulcer bleeding and continue to use aspirin

Aspirin is an effective treatment for acute stroke and heart attack. However, aspirin also induces ulcer and provokes acute ulcer bleeding. Thus, aspirin is often withheld in acute ulcer bleeding but this precipitate recurrent stroke or heart attack. We previously showed that intravenous infusion of a potent acid suppressant substantially reduced the incidence of recurrent ulcer bleeding in patients who withheld aspirin. The aim of this study is to investigate whether intravenous infusion of an acid suppressant (Pantoprazole) is effective in preventing recurrent ulcer bleeding with continuous use of aspirin.

• Cardiovascular Disease
• Cerebrovascular Disorders

Inclusion Criteria:

• Patients received daily anti-platelet therapy for vascular prophylaxis before admission and will continue need to do so
• Patinets with bleeding peptic ulcers;ulcer actively bleeding or with SRH (Forrest I, IIa and IIb ulcers)
• Endoscopic haemostasis achieved

Exclusion Criteria:

• Presence of ulcer complication precluding endoscopic treatment such as gastric outlet obstruction or ulcer perforation mandating surgical intervention.
• Concomitant use of anticoagulant, NSAIDs or steroid
• Pending to undergo cardiac interventions that need double anti-platelet agent
• Pregnancy
• Terminal illness, or cancer