Safety of PPIs in Association with Clopidogrel in Patients with Myocardial Infarction

It's the patient, not the agent — proton-pump inhibitors probably don't lower the effectiveness of clopidogrel.

Many clinicians believe that proton-pump inhibitors (PPIs) lower the effectiveness of clopidogrel (JW Gen Med Jun 8 2010). In this study, researchers reexamined this assumption, using Danish national databases. More than 50,000 patients who were hospitalized for acute myocardial infarction (MI) between 2000 and 2006 and survived longer than 30 days were identified, and data on filled outpatient prescriptions for PPIs and clopidogrel were extracted. The primary outcome was a composite of rehospitalization for MI, stroke, or cardiovascular death.

At 1 year, rates of the primary outcome, categorized by patients' medications, were as follows:

PPI alone — 26%
No PPI or clopidogrel — 19%
Clopidogrel plus PPI — 16%
Clopidogrel alone — 8%

Reviewing Author

Jamaluddin Moloo, MD, MPH

Disclosures

Grant / Research supportColorado Health Foundation

Jamaluddin Moloo, MD, MPH

Disclosures

Grant / Research supportColorado Health Foundation