Impact of PPIs on Clopidogrel Activity Uncertain

This new analysis received no commercial funding, and Dr. Dunn said that he had no financial disclosures to report.

“The event rates were higher in the patients on PPIs, but there is no indication that it was because of the PPIs. It may be because they are sicker patients,” Dr. Bhatt commented.

“I do not think there is enough evidence yet to change practice. Patients who have a clinical indication to be on clopidogrel should certainly remain on it. Likewise, patients who have a good reason to be on a PPI should stay on it,” Dr. Bhatt said in an interview.

He added that a study now in progress should be able to more definitely address this issue because it is prospectively randomizing and comparing post-PCI patients treated with aspirin and clopidogrel alone and those treated with these two drugs plus omeprazole. The Clopidogrel and Optimization of Gastrointestinal Events (COGENT-1) trial has enrolled about 5,000 patients, and is planned to be complete by the end of 2009.

'There is nothing to warrant changing clinical practice, or hesitating to administer a PPI.' DR. BHATT