Key result
Concurrent use of proton pump inhibitors in clopidogrel users was associated with an increased risk of a composite cardiovascular endpoint (HR 1.75; 95% CI 1.58-1.94) compared to non-PPI users.
Why the study?
Does concurrent use of proton pump inhibitors increase the risk of cardiovascular and gastrointestinal events in new clopidogrel users?
Population
18,139 new clopidogrel users identified between January 2006 and December 2007 from a Dutch cohort of 4…
Comparison
Proton pump inhibitors administered concurrently… vs Clopidogrel without concurrent proton pump…
Design
Cohort
Authors
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Should not yet change clopidogrel-PPI co-prescription; leaves open whether the association reflects confounding or a true interaction.
Cohort (n=18,139)
Does concurrent use of proton pump inhibitors increase the risk of cardiovascular and gastrointestinal events in new clopidogrel users?
Hazard Ratio: 1.75 (95% CI 1.58–1.94)
In a large retrospective cohort, concurrent use of PPIs in clopidogrel users was associated with increased cardiovascular and GI risks, though this observation may be heavily influenced by channeling bias and baseline confounding.
Boxel et al. (2010) conducted a cohort in Clopidogrel users (n=18,139). Proton pump inhibitors (PPIs) vs. Clopidogrel without PPIs was evaluated on composite endpoint (HR 1.75, 95% CI 1.58-1.94). Concurrent use of proton pump inhibitors in clopidogrel users was associated with an increased risk of a composite cardiovascular endpoint (HR 1.75; 95% CI 1.58-1.94) compared to non-PPI users.
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