Table 2.
Study design | Follow-up | Number of patients on clopidogrel with/without PPI | End point | Results | Ref. |
Cohort study | 12 yr | PPI: 83; no PPI: 176 | MI, CV death, urgent revascularization | No significant effect of use of PPIs | Collet et al[43] |
Retrospective cohort study | 180 d | PPI: 3996; no PPI: 14 569 | MI, death or coronary revascularization | Adjusted RR for MI or death: 1.22 (95% CI: 0.99-1.51); for revascularization, 0.97 (95% CI: 0.79-1.21) | Rassen et al[47] |
Retrospective cohort study | 1-yr | PPI: 397; no PPI: 138 | MI, death, CABG or repeat PCI | Death, MI events with PPI vs non-PPI groups: 6.7% vs 9.6% (P = 0.32); CABG with PPI vs non-PPI groups: 3.1% vs 4.1% (P = 0.53); revascularization with PPI vs non-PPI groups: 15.8% vs 14.2% (P = 0.65) | Ramirez et al[51] |
Prospective, double-blind placebo- controlled multicentre RCT | Median of 133 d | PPI: 1801; no PPI: 1826 | Cardiovascular events (death, non-fatal MI, CABG or PCI, or ischemic stroke) | Cardiovascular events: HR: 1.02, 95% CI: 0.70-1.51 | Bhatt et al[53] |
Double-blind randomized trial | 6 mo | PPI: 2257; no PPI: 4538 | MACE (CV death, MI, stroke) | MACE in PPI vs no PPI groups after adjustment for potential confounders: 11.8% vs 12.2%, adjusted HR: 0.94 (95% CI: 0.80-1.11, P = 0.46) | O’Donoghue et al[26] |
Retrospective cohort study (FAST-MI Registry) | 1 yr | PPI: 1453; no PPI: 900 | Death, MI, or stroke | No in-hospital difference in death, reinfarction, or major bleeding in PPI vs no PPI groups; Death, MI, or stroke at 1 yr in PPI. no PPI groups: 12% vs 14% (P = 0.72), adjusted OR: 0.98 (95% CI: 0.90-1.08) | Simon et al[54] |
PPI: Proton pump inhibitor; PCI: Percutaneous coronary intervention; MI: Myocardial infarction; RR: Relative risk; CV: Cardiovascular.