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. 2011 May 26;3(5):153–164. doi: 10.4330/wjc.v3.i5.153

Table 2.

Clinical evidences against interaction between clopidogrel and proton pump inhibitors

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.