Joao Paulo de Aquino Lima; James M. Brophy, MD, PhD
Potential Conflicts of Interest: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-1709.
Requests for Single Reprints: James M. Brophy, MD, PhD, Royal Victoria Hospital, 687 Pine Avenue West, R4.12, Montreal, Quebec H3A 1A1, Canada; e-mail, email@example.com.
Current Author Addresses: Mr. de Aquino Lima: 650 Visconde de Maua Street, Fortaleza, Ceará, 60125-160, Brazil.
Dr. Brophy: Royal Victoria Hospital, 687 Pine Avenue West, R4.12, Montreal, Quebec H3A 1A1, Canada.
de Aquino Lima J., Brophy J.; Conflicting Evidence: What's a Clinician to Do?. Ann Intern Med. 2010;153:413-415. doi: 10.7326/0003-4819-153-6-201009210-00011
Download citation file:
Published: Ann Intern Med. 2010;153(6):413-415.
In this issue, Charlot and colleagues (1) use Danish national administrative databases to analyze the association between cardiovascular death, myocardial infarction, or stroke and the concomitant use of proton-pump inhibitors (PPIs) and clopidogrel in patients who have had a myocardial infarction. They report no evidence for a specific drug interaction and find that PPIs were associated with an increased risk for adverse cardiovascular outcomes independent of clopidogrel use. As summarized by Charlot and colleagues, several other studies (2–6) have been published on this subject, and—despite conflicting results—regulatory bodies have issued edicts (7, 8) that warn about a clinically significant drug interaction. How, then, should clinicians interpret this conflicting body of evidence? We propose that a critical systematic review of all of the evidence would certainly help, but that a meta-analysis that combines studies of very uneven scientific quality would not.
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Cardiology, Emergency Medicine, Acute Coronary Syndromes, Coronary Heart Disease.
Results provided by:
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only