PPIs and Cardiovascular Risks

A meta-analysis finds no elevated risk for adverse cardiovascular events with the addition of a PPI to a clopidogrel regimen.

Although dual antiplatelet therapy is the standard of care following coronary stent placement, these drugs are well known to increase the risk for gastrointestinal (GI) bleeding. Although this risk can be significantly reduced with the use of proton-pump inhibitors (PPIs), recent findings from a retrospective pharmacovigilance study suggested a potentially causal association between PPI use and risk for myocardial infarction (NEJM JW Gastroenterol Aug 2015 and PLoS ONE 2015; 10:e0124653).

To further evaluate the risks for adverse cardiovascular events and GI bleeding with concomitant use of clopidogrel and PPIs, researchers conducted a systematic review and meta-analysis including 39 studies involving 214,851 patients receiving clopidogrel, …

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors