Proton-Pump Inhibitors and Clopidogrel: Bad Company?

In a large observational cohort of ACS patients, this drug combination was associated with poorer outcomes than clopidogrel alone.

Proton-pump inhibitors (PPIs) are often prescribed to minimize gastrointestinal bleeding in patients taking clopidogrel after acute coronary syndromes (ACS). However, findings from small studies suggest that PPIs may reduce clopidogrel’s efficacy. To determine whether such an interaction could have important clinical effects, investigators assessed outcomes in 8025 patients with ACS who were discharged from Veterans Affairs hospitals nationwide and who received clopidogrel with or without a PPI. The primary outcome was the composite of all-cause mortality and rehospitalization for ACS.

A majority (63.9%) of the patients were prescribed a PPI in conjunction with clopidogrel. In multivariable analysis, the use of a PPI with clopidogrel was ass…

Reviewing Authors

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)

David Green, MD, PhD

Disclosures

EquityNovartis

David Green, MD, PhD

Disclosures

EquityNovartis

Proton-Pump Inhibitors and Clopidogrel: Bad Company?

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Reviewing Authors