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Influence of the Concomitant Use of Clopidogrel and Proton Pump Inhibitors on Adverse Cardiovascular Events in Korean Patients with Acute Coronary Syndrome

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±è¼öÇö(Kim Su-Hyun) - ¿©Àǵµ¼º¸ðº´¿ø ¾àÁ¦ÆÀ
ÀÌÀ¯Á¤(Lee Yu-Jeung) - °­¿ø´ëÇб³ ¾àÇдëÇÐ

Abstract

Purpose: Recent investigations suggest that the antiplatelet effect of clopidogrel may be decreased when this medication is taken together with certain proton pump inhibitors (PPIs). However, there has been no study conducted in Korea regarding the clinical effect of clopidogrel-PPI interaction. This study targeted patients who received stents to investigate the effect of the concomitant use of clopidogrel and PPIs on the occurrence of adverse cardiovascular events in Korean patients.

Methods: The patients who received a stent insertion at the Yeouido St. Mary¡¯s Hospital between January 2010 and April 2011 were included. The patients were divided into two groups, clopidogrel and clopidogrel + PPI, and followed for 12 months after the date of stent insertion using prescription history and medical records. The recurrence rates of the cardiovascular events among the two patient groups were statistically analyzed.

Results: There was no difference between the two groups in the basic characteristics of the 157 patients in the clopidogrel group and the 62 patients in the clopidogrel + PPI group. Simple logistic regression showed a significantly higher rate of re-hospitalization in the clopidogrel + PPI group (OR=1.893, 95% CI 1.040-3.445, p=0.037). However, the
results of the multivariate logistic regression of the variables found to have statistical significance by crosstabulation showed no significant difference in the rate of adverse cardiovascular events or re-hospitalization between the two groups.
Conclusions: There was no significant difference between the clopidogrel and clopidogrel+PPI group among new patients with cardiovascular stents with respect to the occurrence of revascularization procedures, stent thrombosis, or chest pain, or with respect to the re-hospitalization rate for all cardiovascular events.

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clopidogrel, proton pump inhibitors, interaction, adverse cardiovascular events, acute coronary syndrome
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DOI
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ICD 03
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