Table 1. Summary of studies examining the link between PPI and Clopidogrel concomitant use.

PPI- proton pump inhibitor; RCT- randomized control trial; bd- twice daily; od- once daily; PAD- peripheral arterial disease; DAPT- dual antiplatelet therapy; ACS- acute coronary syndrome

Study (year)	Design	Total patients (patients taking PPIs)	Patient condition	PPI assigned	Medications assigned	Comments
Moayyedi et al. (2019) [18]	RCT	17,598 (8,791)	Stable cardiovascular disease and PAD	Pantoprazole 40mg daily	Rivaroxaban (2.5mg bd) with Aspirin (100mg od), Rivaroxaban (5mg bd), Aspirin (100mg)	No statistically significant difference between groups
Przespolewski et al. (2018) [19]	RCT	28 (28)	Healthy male	40mg Pantoprazole, 20mg Omeprazole, 20mg Rabeprazole, 40mg Esomeprazole, 30mg Lansoprazole, 30mg Dexlansoprazole	Clopidogrel 75mg daily	Aggregation did not increase significantly with PPI-Clopidogrel use
Vaduganathan et al. (2016) [20]	RCT	Low dose Aspirin-2,480 (1,231), High dose Aspirin-1,272 (638)	Patients requiring DAPT treatment for at least 12 months	Omeprazole 20mg	Clopidogrel 75mg	Randomized PPIs did not affect the cardiovascular outcome of patients
Bhurke et al. (2012) [21]	Retrospective cohort study	5,348 (2,674)	ACS patients with Clopidogrel prescription	Any identified PPI use	Clopidogrel	Increased risk of adverse cardiovascular events with PPI-Clopidogrel use
Juurlink et al. (2009) [22]	Nested case-control study	Controls- 2,057 (424), Cases- 734(194)	Controls- Event-free patients after MI Cases-patients readmitted following an acute MI	Pantoprazole-46/734, Other-148/734	Clopidogrel	PPI-Clopidogrel use showed increased risk in elderly with reinfarction, barring Pantoprazole