Review for 10.1186/s12876-024-03269-w (2024)

Title: Widespread use of proton pump inhibitors or potassium-competitive acid blocker has
changed the status of gastrointestinal bleeding in patients with ischemic heart disease: Real-
world data from high volume centers
Version: 6 Date: 19 Apr 2024
Reviewer's report:
"PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
No - there are major issues
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are major issues
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
No - there are major issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
No - there are issues with the statistics in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
No - there are major issues
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The aim of the article was to investigate the current role of PPI in
GIT bleeding within 2 years after PCI. This is a retrospective study that included patients who
underwent PPI during 2018 and 2019. The authors investigated the incidence of bleeding among
these patients within next 2 years. The topic is not novel, data are already known and therefore
the rational for this kind of study in 2024 is not clear enough. Authors should elaborate this in
the introduction section.
The authors responded on the previous suggestions of reviewers, however, there are many other
points that need clarification.
REQUESTED REVISIONS:
1. In the abstract you claim that you will investigate the current status of PPI in GIT after
PCI. However, your patients were included 5-6 years ago and this is not quite the definition of
“current”. Therefore, I would suggest to omit this word.
2. You mention A and B groups in abstract without defining them previously. Please change this.
3. All continuous values should be reported as average # SD. For example: X # SD vs. Y #
SD; p<0.01.
4. Which drugs are acid secretion inhibitors? Potassium-competitive acid blocker?
5. The introduction is too long and not very informative. Please rewrite it.
6. In the title of the manuscript, you mentioned PPI and in the rest of manuscript “acid secretion
inhibitors”. These are not synonyms. Please clarify this. H2 antagonists, as well as other drugs,
may be acid secretion inhibitors. Which group of drugs you investigated?
7. I am not sure that I understand why you mentioned these risk factors in methodology section.
These are parameters that you followed and afterwards you will detect if they are risk factors
or not. Please elaborate this.
8. Vonoprazan is a potassium-competitive acid blocker, very novel for Europe and US and
not PPI. Were all patients on this drug? They were actually not taking PPI? If you included
only vonoprazan than you title and the introduction about the role of PPI is misleading. Please
elaborate this.
9. Why vonoprazan was given to patients instead of PPI (pantoprasol, omeprasol, esomeprasol)?
Were all patients on vonoprazan or some were on some other drug?
10. Table 4 is not necessary. You need to present summary and not each case. This is not case
series, but original article. Add the acronyms below table with their explanation.
11. In discussion you keep repeating your results, which should not be the point of article. You
should compare them with the literature.
12. Where is the table with logistic regression analysis?
13. How bleeding was detected? You have very small incidence of bleeding.
14. Conclusion is very short and uninformative. Please rewrite it.
15. English should be significantly improved."