What does this research mean for the field?

The concomitant use of proton pump inhibitors with clopidogrel after percutaneous coronary intervention is not associated with an increased risk of major adverse cardiovascular events or net adverse clinical events. Novelty: ClaimNovelty.CONTRADICTORY. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

What question did this study set out to answer?

This research aims to explore the impact of proton pump inhibitors (PPIs) on clinical outcomes in patients using clopidogrel post-PCI. The focus is on adverse events like major adverse cardiovascular events (MACE).

March 9, 2011Circulation Cardiovascular Interventions

Clinical Outcomes in Patients With the Concomitant Use of Clopidogrel and Proton Pump Inhibitors After Percutaneous Coronary Intervention

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Why the study?

Does the concomitant use of proton pump inhibitors with clopidogrel increase the risk of adverse cardiovascular or bleeding events in patients after percutaneous coronary intervention?

Key Points

This research aims to explore the impact of proton pump inhibitors (PPIs) on clinical outcomes in patients using clopidogrel post-PCI. The focus is on adverse events like major adverse cardiovascular events (MACE).
2651 patients after coronary stenting for coronary artery disease were analyzed from 2001 to 2007.
Patients were grouped into PPI (+) and PPI (-) for comparison of 6-month clinical outcomes.
Utilized propensity-adjusted and propensity-matched analyses to assess risk of MACE and net adverse clinical events (NACE).
No increase in the risk of MACE for the PPI (+) group compared to PPI (-) with hazard ratio not specified.
NACE rates did not differ significantly between groups, demonstrating no adverse outcomes associated with PPI use.
Results held true in both propensity-adjusted and matched analyses.

Structured PICO

Does the concomitant use of proton pump inhibitors with clopidogrel increase the risk of adverse cardiovascular or bleeding events in patients after percutaneous coronary intervention?

Population

2651 consecutive patients discharged alive after coronary stenting for stable or unstable coronary artery disease between 2001 and 2007. All patients received aspirin indefinitely and a thienopyridine for 1 to 12 months.

Intervention

Proton pump inhibitors (PPIs) added to dual antiplatelet therapy (aspirin and clopidogrel)

Comparator

Dual antiplatelet therapy (aspirin and clopidogrel) without a proton pump inhibitor

Outcome

6-month incidence of major adverse cardiovascular events (MACE) (composite of death, myocardial infarction, target vessel revascularization, and stent thrombosis) and net adverse clinical events (NACE) (composite of MACE and thrombolysis in myocardial infarction major or minor bleeding)composite

The concomitant use of proton pump inhibitors with clopidogrel after percutaneous coronary intervention does not appear to increase the risk of adverse cardiovascular or bleeding events.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

No excess MACE or NACE with PPIs plus clopidogrel post-PCI; challenges prior concerns but leaves open need for RCTs.

Cite This Study

Harjai et al. (2011) studied this question.

synapsesocial.com/papers/6a23a919fdd7df511fd31af7 https://doi.org/10.1161/circinterventions.110.958884

Topics

Dual antiplatelet therapy

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Clinical Outcomes in Patients With the Concomitant Use of Clopidogrel and Proton Pump Inhibitors After Percutaneous Coronary Intervention

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Clinical Outcomes in Patients With the Concomitant Use of Clopidogrel and Proton Pump Inhibitors After Percutaneous Coronary Intervention

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider