In this retrospective cohort of over 8000 patients with ACS in over 120 VA hospitals, researchers examined the rate of death or ACS re-hospitalization in clopidogrel patients, comparing those with or without PPI therapy. Over 28 months, patients on PPI’s met the primary outcome 30% of the time, compared to 21% in those not on PPI’s. Given that almost 2/3 of these patients were discharged on clopidogrel, this is a substantial number of patients potentially affected. We should closely examine the risks and benefits of PPI’s at the time of discharge in post-ACS patients on clopidogrel (abstract), bearing in mind the recent guidelines endorsing PPI’s for patients with dual anti-platelet therapy (guideline summary).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.