Evolving trends in acid suppression therapy among patients undergoing dual antiplatelet therapy: A Nationwide study in South Korea from 2018 to 2022

Abstract Aims We aimed to examine the recent trends in the use of acid suppression therapies, including proton pump inhibitors (PPIs), histamine‐2 receptor antagonists (H2RAs) and potassium‐competitive acid blockers (P‐CABs), in patients undergoing dual antiplatelet therapy (DAPT) as aspirin‐clopidogrel following coronary stent implantation in South Korea between 2018 and 2022. Methods This observational study analysed data from the Health Insurance Review and Assessment Service (HIRA) on patients who underwent coronary stent implantation and received aspirin‐clopidogrel DAPT. Patients who received acid suppression therapy for >60 days during DAPT were included in the analysis. Trends in the use of PPIs, H2RAs and P‐CABs were assessed at 6‐month intervals using the Cochran–Armitage trend test. Results Of the 128 121 patients studied who received DAPT, 61 731 (48.2%) were prescribed acid suppression therapy. The proportion of patients receiving concomitant acid suppressants with DAPT increased from 42.8% in 2018 to 53.8% in 2022. PPIs were the most commonly used therapies (78.9%), followed by H2RAs (14.6%) and P‐CABs (6.5%). PPI use peaked in 2020 and declined thereafter, whereas P‐CAB use steadily increased, surpassing that of H2RA by 2021. Conclusions The landscape of acid suppression therapy for patients undergoing DAPT has evolved with a growing preference for P‐CABs. This shift highlights the need for further research comparing the efficacy and safety of acid suppressants to guide clinical decision making.