Key result
Concomitant use of proton pump inhibitors was not associated with increased risk of death, re-infarction, or severe bleeding in ACS patients on clopidogrel (HR 1.036) or ticagrelor (HR 2.320).
Why the study?
Does concomitant use of proton pump inhibitors and clopidogrel or ticagrelor increase adverse clinical outcomes in patients with acute coronary syndrome after percutaneous coronary intervention?
Cohort (n=9,429)
Yes
Does concomitant use of proton pump inhibitors and clopidogrel or ticagrelor increase adverse clinical outcomes in patients with acute coronary syndrome after percutaneous coronary intervention?
Hazard Ratio: 1.036 (95% CI 0.903–1.189)
Concomitant use of PPIs with clopidogrel or ticagrelor in patients with ACS following PCI is not associated with an increased risk of adverse outcomes, supporting their combined use when indicated for gastrointestinal protection.
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No increased risk seen with PPIs plus ticagrelor; leaves open possible interaction given wide CI.
Yan et al. (2016) conducted a cohort in Acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) (n=9,429). Proton pump inhibitors (PPIs) vs. No PPI use was evaluated on 1-year composite of all-cause death, re-infarction, or severe bleeding (HR 1.036, 95% CI 0.903-1.189). Concomitant use of proton pump inhibitors was not associated with increased risk of death, re-infarction, or severe bleeding in ACS patients on clopidogrel (HR 1.036) or ticagrelor (HR 2.320).
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