October 28, 2008Circulation

Abstract 3999: Baseline Proton Pump Inhibitor Use is Associated with Increased Cardiovascular Events With and Without the Use of Clopidogrel in the CREDO Trial

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Why the study?

Does baseline PPI use increase cardiovascular events in patients undergoing PCI treated with clopidogrel?

Population

Patients undergoing, or at high likelihood of undergoing, PCI in the CREDO trial

Comparison

Baseline proton pump inhibitor (PPI) use vs No baseline PPI use

Design

Cohort, randomized to a loading dose and 1-year clopidogrel versus just 4…

Follow-up

1 year

Authors

SDSteven P. DunnUniversity of Virginia TMTracy E. MacaulayUniversity of Kentucky DBDanielle M. BrennanGeneral / Preventive / Lipids

Discussion

Member takes

Implication

PPI use associated with higher post-PCI events without blunting clopidogrel benefit; leaves open causality and needs prospective confirmation.

Structured PICO

Does baseline PPI use increase cardiovascular events in patients undergoing PCI treated with clopidogrel?

Population

Patients undergoing, or at high likelihood of undergoing, PCI in the CREDO trial

Intervention

Baseline proton pump inhibitor (PPI) use

Comparator

No baseline PPI use

Outcome

28-day composite (Death/MI/UTVR) and 1-year composite (Death/MI/Stroke)composite

Baseline PPI use is associated with increased cardiovascular risk in PCI patients, but does not diminish the clinical efficacy of prolonged clopidogrel therapy.

Cite This Study

Dunn et al. (2008) studied this question.

synapsesocial.com/papers/69ffcb977e61d2a3f0c23097 https://doi.org/10.1161/circ.118.suppl_18.s_815-a

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Implication

PPI use associated with higher post-PCI events without blunting clopidogrel benefit; leaves open causality and needs prospective confirmation.