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PPIs prescribed with clopidogrel 'increases risk of heart attack'

Prescribing PPIs along with clopidogrel and aspirin in patients who have suffered a heart attack or have unstable angina may put them at increased risk of heart attack or death.

A retrospective study of 8,205 patients in the US with acute coronary syndrome taking clopidogrel following hospitalisation found prescribing clopidogrel in addition to omeprazole increased the risk of death or rehospitalisation by 25%, compared with the use of the use of clopidogrel without a PPI.

There was no association between the use of PPI without clopidogrel and death or rehospitalisation among patients not taking clopidogrel after discharge from hospital.

JAMA. 2009;301:937-44

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