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PPI-clopidogrel mix more than doubles risk of death



By Lilian Anekwe

Co-prescribing clopidogrel and PPIs more than doubles the risk of death in stroke patients, say the authors of a retrospective review of primary care patient records.

The US researchers analysed prescribing in 280 patients with a mean aged of 76 years at the time of the first stroke. After nearly four years of follow-up the researchers found patients who were co-prescribed clopidogrel and a PPI were 2.9 times more at risk of death to those prescribed clopidogrel.

Other significant predictors of death included use of a COX-2 inhibitor following a stroke, which raised the risk of death by 2.4 times, and a thiazide diuretic, which also increased the risk by 2.4 times.

Prescribing PPIs or clopidogrel individually did not affect the risk of death, nor did any other medications.

Study leader Dr Sibi Krishnamurthy, a researcher at Duke University in North Carolina concluded: ‘Our data suggests that the hypothesis that the combination of PPI medications and clopidogrel may increase the risk of death in elderly stroke patients.’

International Stroke Conference 2010, poster no P143.