Heartburn drugs may reduce activity of clopidogrel in patients with coronary stents
08 may 2009-- In patients prescribed clopidogrel after coronary stenting, the use of proton pump inhibitors may significantly increase the risk of major adverse cardiovascular events, suggesting that the heartburn drugs interfere with clopidogrel's antiplatelet activity, according to research presented at the annual meeting of the Society for Cardiovascular Angiography and Interventions, held from May 6 to 9 in Las Vegas.
Eric J. Stanek, of Medco Health Solutions in Franklin Lakes, N.J., and colleagues compared one-year outcomes in 16,690 patients, including 41 percent who took a proton pump inhibitor for more than nine months of the year. Compared to patients who didn't take proton pump inhibitors, the researchers found that proton pump inhibitor users had a 51 percent increased risk of major adverse cardiovascular events. They also found that the increased risk ranged from 39 percent in omeprazole and lansoprazole users to 57 percent in esomeprazole users and 61 percent in pantoprazole users. "Given the large number of patients who undergo coronary stent procedures each year, and the recommended and wide use of clopidogrel following this procedure, our findings have implications for many thousands of patients across the United States," Stanek said in a statement. "Clopidogrel should continue to be taken as prescribed, and the need for proton pump inhibitor therapy should be carefully evaluated to ensure that it is prescribed only when clearly indicated." This study was supported by Medco Health Solutions Inc.
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