In this retrospective cohort of over 8000 patients with ACS in over 120 VA hospitals, researchers examined the rate of death or ACS re-hospitalization in clopidogrel patients, comparing those with or without PPI therapy. Over 28 months, patients on PPI’s met the primary outcome 30% of the time, compared to 21% in those not on PPI’s. Given that almost 2/3 of these patients were discharged on clopidogrel, this is a substantial number of patients potentially affected. We should closely examine the risks and benefits of PPI’s at the time of discharge in post-ACS patients on clopidogrel (abstract), bearing in mind the recent guidelines endorsing PPI’s for patients with dual anti-platelet therapy (guideline summary).
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