Key result
Systematic review of 33 clinical studies found highly heterogeneous risk ratios (0.64 to 4.58) for MACE, failing to substantiate an adverse clinical effect of adding PPIs to clopidogrel.
Why the study?
Does the addition of proton pump inhibitors to clopidogrel reduce platelet inhibition and worsen cardiovascular outcomes in patients on clopidogrel?
Population
Patients using clopidogrel for acute coronary syndromes or stent implantation for stable coronary disease…
Comparison
Addition of proton pump inhibitors to clopidogrel vs Clopidogrel without proton pump inhibitors
Design
Systematic_review
Authors
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Supports PPI co-prescription with clopidogrel without MACE concern; challenges translation of ex vivo platelet data to clinical outcomes.
Systematic Review
Does the addition of proton pump inhibitors to clopidogrel reduce platelet inhibition and worsen cardiovascular outcomes in patients on clopidogrel?
Despite ex vivo evidence of reduced antiplatelet activity, systematic review of clinical data does not substantiate an adverse effect of PPI use on cardiovascular outcomes in clopidogrel users.
Focks et al. (2012) conducted a systematic review in Acute coronary syndromes or stable coronary disease with stent implantation. Proton pump inhibitors (PPIs) vs. Clopidogrel without PPIs was evaluated on Platelet function and major adverse cardiovascular events. Systematic review of 33 clinical studies found highly heterogeneous risk ratios (0.64 to 4.58) for MACE, failing to substantiate an adverse clinical effect of adding PPIs to clopidogrel.
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