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Evid Based Med 18:e30 doi:10.1136/eb-2012-100983
  • Aetiology
  • Cohort study

Lack of association between proton pump inhibitors and adverse events in patients taking clopidogrel and aspirin

  1. Michael A Gaglia Jr2
  1. 1Department of Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
  2. 2Department of Cardiology, University of Southern California, Los Angeles, California, USA
  1. Correspondence to : Dr Ron Waksman
    MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA; ron.waksman{at}medstar.net

Commentary on

Context

Clopidogrel inhibits the P2Y12 platelet receptor and is used in patients with acute coronary syndromes or ischaemic stroke to prevent recurrent vascular events. Proton pump inhibitors (PPIs), however, have been shown to reduce the pharmacodynamic effect of clopidogrel upon platelet inhibition, and have been linked in retrospective studies to a higher rate of ischaemic outcomes in patients taking clopidogrel.

Methods

A total of 24 471 patients in the General Practice Research Database in the UK (beginning in 2003) concurrently prescribed aspirin and clopidogrel were included. There were 12 439 (50%) patients receiving a PPI at some point during the study. The exposure of interest was prescription of a …

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