Herbert D. Aronow, MD, MPH
In adults hospitalized for myocardial infarction (MI), is adding clopidogrel to proton-pump inhibitors (PPIs) associated with increased risk for cardiovascular (CV) events?
Retrospective cohort study with linkage of several national registries; follow-up was 1 year after hospital discharge.
Population-based study in Denmark.
56 406 patients > 30 years of age (mean age 68 y, 59% men) who were hospitalized with a first acute MI between 2000 and 2006, survived ≥ 30 days after discharge, and had complete data sets.
Filled prescriptions for clopidogrel within 30 days of discharge or PPIs within 1 year of discharge.
CV events (CV death or rehospitalization for MI or stroke). Secondary outcomes included all-cause mortality.
44% of patients filled a prescription for clopidogrel within 30 days of discharge, and 28% filled ≥ 1 prescription for PPIs. Use of PPIs was associated with increased risk for CV events and mortality regardless of concomitant clopidogrel prescription (Table). Adding clopidogrel to PPIs was not associated with an increased risk for CV events but was associated with greater mortality than PPIs alone (Table).
In adults hospitalized for myocardial infarction, adding clopidogrel to proton-pump inhibitors was not associated with increased risk for cardiovascular events.
Associations between clopidogrel and proton-pump inhibitors (PPIs) and cardiovascular (CV) events or mortality in adults hospitalized for acute myocardial infarction*
*CI defined in Glossary. Analysis based on time-dependent Cox proportional hazard model. Adjusted for multiple potentially confounding variables.
†Compared with no PPI therapy.
‡CV death or hospitalization for myocardial infarction or stroke.
Aronow HD. Adding clopidogrel to proton-pump inhibitors was not associated with increased CV risk after MI. Ann Intern Med. ;153:JC6–13. doi: 10.7326/0003-4819-153-12-201012210-02013
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Published: Ann Intern Med. 2010;153(12):JC6-13.
Cardiology, Coronary Risk Factors, Prevention/Screening.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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