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Some research has suggested a potential risk for reduced efficacy of clopidogrel with use of proton-pump inhibitors (PPIs; JW Gen Med Feb 23 2010). To assess the clinical effect of this combination in stroke patients, these authors conducted a nested case–control study of all residents of Ontario, Canada aged ≥66 who were newly treated with clopidogrel after a stroke or transient ischemic attack. Among 2765 patients entering the cohort, 118 were readmitted for stroke within 180 days after the initial admission; another 472 patients matched to cases by age, sex, and index event who remained stroke-free during follow-up were designated as controls. Of the total cohort, 27% had a postdischarge prescription for a PPI.
After multivariable adjustm…