There is ongoing controversy of how clinically significant it is that PPIs reduce the anti-platelet effect of clopidogrel. In this case-control of patients who had a stroke / TIA and who were started on clopidogrel, those who were also on a PPI did not have an increased risk of subsequent stroke or death, compared to those not on a PPI. Similar to the recommendations for patients on clopidogrel for cardiovascular protection, those on clopidogrel for cerebrovascular protection who also require a PPI should probably be on pantoprazole (instead of omeprazole or esomeprazole) (abstract)
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February 14, 2011 |
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About the Author: Danielle Scheurer
Danielle Scheurer, MD, MSCR, SFHM is a clinical hospitalist and the Chief Quality Officer at the Medical University of South Carolina in Charleston, South Carolina, where she also serves as 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 is also the President of SHM's Board of Directors and previously served as Physician Editor of The Hospitalist, SHM's monthly newsmagazine.
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