Is there an increased risk of adverse cardiovascular events in patients taking a PPI with clopidogrel?
Abstract
Omeprazole does not appear to increase the risk of adverse cardiovascular outcomes in patients with known coronary artery disease taking aspirin and clopidogrel (SOR: B, randomized controlled trial [RCT] and meta-analysis of observational studies). Pantoprazole and esomeprazole may be associated with an increased risk of cardiovascular events in patients taking clopidogrel (SOR:B, meta-analysis of observational studies). Conflicting data exist for outcomes with lansoprazole (SOR: B, meta-analysis of observational studies and subgroup analysis of RCT). Copyright © 2019 by Family Physicians Inquiries Network, Inc. DOI 10.1097/EBP.0000000000000356
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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