title: Major adverse cardiac events among postpercutaneous coronary intervention patients on clopidogrel and proton pump inhibitors.
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.
authors.affiliation: University of Connecticut Health Center, Farmington, USA.
authors.forename: Gilbert G
authors.initials: GG
authors.lastname: Ching
authors.forename: Dadong
authors.initials: D
authors.lastname: Li
authors.forename: William L
authors.initials: WL
authors.lastname: Baker
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Hohl
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Mather
authors.forename: Raymond G
authors.initials: RG
authors.lastname: McKay
authors.forename: Justin B
authors.initials: JB
authors.lastname: Lundbye
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D000077144:Clopidogrel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine