Patients on dual antiplatelet therapy showed no increase in cardiovascular events while receiving omeprazole to lower risks for gastrointestinal bleeding, according to a New England Journal of Medicine study.
In a double-blind trial, 3700 patients were randomized to receive the proton-pump inhibitor (PPI) omeprazole or placebo, while taking both aspirin and clopidogrel. The study had two primary endpoints: gastrointestinal bleeding or pain, and cardiovascular events, such as cardiovascular death, MI, or ischemic stroke. (Cogentus Pharmaceuticals, the manufacturer of the clopidogrel-omeprazole combination pill, designed and sponsored the trial, but the company is now defunct.)
Over the course of a median follow-up of 106 days, gastrointestinal events were significantly less frequent with clopidogrel-omeprazole. Cardiovascular event rates were also less frequent, but not significantly so (4.9% vs. 5.7%).
The authors say the outcome "provides reassurance that there is no clinically significant cardiovascular interaction between PPIs and clopidogrel."
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