Proton-Pump Inhibitors and Cardiovascular Risk

In a population-wide cohort study, use of a PPI was an independent predictor of poor outcome after myocardial infarction, regardless of clopidogrel use.

Clopidogrel is standard therapy in coronary stent recipients. Many stent recipients take proton-pump inhibitors (PPIs) as well; therefore, evidence that PPIs reduce the antiplatelet effects of clopidogrel has aroused great concern. These investigators examined registry data on 56,406 patients hospitalized with myocardial infarction (MI) in Denmark to assess the risks for adverse cardiovascular events associated with clopidogrel and PPIs used alone and concomitantly. The primary outcome was a composite of MI, stroke, and cardiovascular death.

Of 24,704 patients who claimed a prescription for clopidogrel within 30 days of discharge, 6753 received PPIs during 1-year follow-up. The use of PPIs was similar in clopidogrel recipients and nonrecipie…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute