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Conn Med. 2012 Apr;76(4):205-11.

Major adverse cardiac events among postpercutaneous coronary intervention patients on clopidogrel and proton pump inhibitors.

Author information

1
University of Connecticut Health Center, Farmington, USA.

Abstract

OBJECTIVE:

To determine if concomitant use of proton pump inhibitors (PPIs) and clopidogrel is associated with adverse events among postpercutaneous coronary intervention (PCI) patients.

METHODS:

This is a single-center, retrospective case-control study of 3,287 consecutive patients on clopidogrel who underwent PCI. Univariate and multivariate analyses determined if concomitant PPI and clopidogrel use was associated with major adverse cardiac events (MACE).

RESULTS:

There were significantly more deaths (3.0% vs 1.1%; P < 0.001), repeat revascularizations (3.8% vs 2.1%; P = 0.005) and MACE (7.1% vs 3.5%; P < 0.001) in the clopidogrel and PPI group. Cox regression revealed that PPI is an independent predictor of MACE (HR 1.70, 95% CI of 1.20-2.41; P = 0.003), mortality (HR 1.79; 95% CI 1.03-3.12, P = 0.038), and target-vessel revascularization (HR 1.75; 95% CI 1.12-2.72, P = 0.014).

CONCLUSIONS:

Concomitant use of PPIs and clopidogrel among post PCI patients was associated with increased rates of all-cause mortality, target vessel revascularization, and combined MACE at nine months follow-up.

PMID:
22611719
[Indexed for MEDLINE]

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