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Proton Pump Inhibitors May Reduce Benefits of Clopidogrel

Concurrent use of both drugs after acute coronary syndrome linked to higher risk of adverse outcomes

TUESDAY, Mar. 3 (HealthDay News) -- Acute coronary syndrome patients who are prescribed clopidogrel in combination with a proton pump inhibitor are at increased risk of adverse outcomes compared with patients prescribed clopidogrel alone, according to a report published in the Mar. 4 issue of the Journal of the American Medical Association.

P. Michael Ho, M.D., Ph.D., of Denver VA Medical Center, and colleagues conducted a study of 8,205 patients with acute coronary syndrome who had been discharged from hospital and were taking clopidogrel, of whom 5,244 (63.9 percent) were also taking a proton pump inhibitor.

Among the patients prescribed proton pump inhibitors, the death or rehospitalization rate was 29.8 percent (1,561 patients), versus 20.8 percent (615 patients) in the group not taking a proton pump inhibitor, the investigators found. There was a 25 percent increased risk of death or rehospitalization for acute coronary syndrome among patients prescribed both drugs compared to those prescribed clopidogrel alone, the researchers report.

"Pending further studies to confirm these results and prospectively assess cardiovascular outcomes for patients taking clopidogrel plus proton pump inhibitors versus clopidogrel without proton pump inhibitors, the results of this study may suggest that proton pump inhibitors should be used for patients with a clear indication for the medication, rather than routine prophylactic prescription," the authors write.

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