Abstract
Abstract: Clopidogrel as an adjunct to aspirin has improved outcomes after acute coronary syndromes and coronary stent implantation. Patients with CV co-morbidities, receiving antiplatelet agents because of their usefulness in primary or secondary cardiovascular prevention, present a significantly increased GI risk; therefore in those patients gastroprotective agents are useful to reduce this risk. Laboratory studies suggested a reduced antiplatelet effect when proton pump inhibitors (PPIs) are co-administered; those data were corroborated from large retrospective studies. Strong evidence from RCTs and systematic review evaluating the clinical interaction between PPI and clopidogrel failed to demonstrate difference in cardiovascular outcomes, confirming a significant reduction in gastrointestinal bleeding in PPI users. To date, the available evidences do not support the warning that PPI prescription could worsen clinical outcome of patients receiving clopidogrel.
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