Heart patients given a drug combination to reduce gastrointestinal bleeding are more likely to die, a study at Denver VA Medical Center in the US has warned.
All the patients in the study had been treated for acute coronary syndrome (ACS) and were also taking proton pump inhibitor (PPI) medications and the anti-bleeding drug clopidogrel.
The Journal of the American Medical Association (JAMA) reports that death or rehospitalisation occurred in 29.8% of patients prescribed clopidogrel plus PPI and 20.8% of patients prescribed clopidogrel without PPI.
It concludes that clopidogrel with PPI was linked to a 25% increase in the chances of dying or being readmitted to hospital for ACS compared with clopidogrel without PPI.
Recent studies have suggested that PPIs may reduce the effectiveness of clopidogrel, but until this study, the significance of these findings had not been clear.
Writes Dr Michael Ho: “When patients were not taking clopidogrel after hospital discharge, a prescription for PPI was not associated with death or rehospitalisation for ACS.
“This supports the hypothesis that the interaction of PPI and clopidogrel, rather than PPI itself, was associated with increased adverse outcomes.”
Copyright Press Association 2009