ArticleBMJ (Clinical research ed.)2012
Clopidogrel and interaction with proton pump inhibitors: comparison between cohort and within person study designs.
Article in BMJ (Clinical research ed.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- Meta-Analysis of Efficacy and Safety of Proton Pump Inhibitors with Dual Antiplatelet Therapy for Coronary Artery Disease.Cardiovascular revascularization medicine : including molecular interventions · 2019Pooled it
- Is the concomitant use of clopidogrel and Proton Pump Inhibitors still associated with increased adverse cardiovascular outcomes following coronary angioplasty?: a systematic review and meta-analysis of recently published studies (2012 - 2016).BMC cardiovascular disorders · 2017Pooled it
- Cardiovascular Risk with Prokinetics: A Self-Controlled Case Series Study Using a Korean Nationwide Health Claims Database.Cardiovascular toxicology · 2025Article
- Article
- Impact of Concomitant Use of Proton Pump Inhibitors and Clopidogrel on Recurrent Stroke and Myocardial Infarction.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Oral Bisphosphonates Are Associated With Increased Risk of Severe Acute Kidney Injury in Elderly Patients With Complex Health Needs: A Self-Controlled Case Series in the United Kingdom.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2022Article
- Transparency of high-dimensional propensity score analyses: Guidance for diagnostics and reporting.Pharmacoepidemiology and drug safety · 2022Article
- Proton pump inhibitors and risk of all-cause and cause-specific mortality: A cohort study.British journal of clinical pharmacology · 2021Article
- Assessing the impact of preventive mass vaccination campaigns on yellow fever outbreaks in Africa: A population-level self-controlled case series study.PLoS medicine · 2021Article
- Risk of Adverse Cardiovascular Events Following a Myocardial Infarction in Patients Receiving Combined Clopidogrel and Proton Pump Inhibitor Treatment: A Nested Case-Control Study.Drugs - real world outcomes · 2020Article
- Risk of Hospitalization With Hemorrhage Among Older Adults Taking Clarithromycin vs Azithromycin and Direct Oral Anticoagulants.JAMA internal medicine · 2020Article
- Comparison of Self-controlled Designs for Evaluating Outcomes of Drug-Drug Interactions: Simulation Study.Epidemiology (Cambridge, Mass.) · 2019Article
- Contemporary Prescription Patterns of Adenosine Diphosphate Receptor Inhibitors in Acute Coronary Syndrome.P & T : a peer-reviewed journal for formulary management · 2018Article
- Consensus Document ANMCO/ANCE/ARCA/GICR-IACPR/GISE/SICOA: Long-term Antiplatelet Therapy in Patients with Coronary Artery Disease.European heart journal supplements : journal of the European Society of Cardiology · 2018Article
- Discontinuing Long-Term PPI Therapy: Why, With Whom, and How?The American journal of gastroenterology · 2018Review
- Pharmacoepidemiology for nephrologists: do proton pump inhibitors cause chronic kidney disease?Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2017Review
- Comparison of prophylactic effect of UGIB and effects on platelet function between PPIs and HTherapeutics and clinical risk management · 2017Article
- Prescription of renin-angiotensin system blockers and risk of acute kidney injury: a population-based cohort study.BMJ open · 2016Article
- The first six-month clinical outcomes and risk factors associated with high on-treatment platelet reactivity of clopidogrel in patients undergoing coronary interventions.Anatolian journal of cardiology · 2016Article
- Potential harms of proton pump inhibitor therapy: rare adverse effects of commonly used drugs.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2016Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo measure the association between use of proton pump inhibitors and a range of harmful outcomes in patients using clopidogrel and aspirin.
designObservational cohort study and self controlled case series.
settingUnited Kingdom General Practice Research Database with linked data from the Myocardial Ischaemia National Audit Project (MINAP) and the Office for National Statistics (the cardiovascular disease research using linked bespoke studies and electronic records (CALIBER) collaboration) POPULATION: 24,471 patients receiving clopidogrel and aspirin.
main outcome measuresThe primary outcome was death or incident myocardial infarction. Secondary outcomes were death, incident myocardial infarction, vascular death, and non-vascular death. Comparisons were made between proton pump inhibitor use and non-use.
resultsOf the 24,471 patients prescribed clopidogrel and aspirin, 12,439 (50%) were also prescribed a proton pump inhibitor at some time during the study. Death or incident myocardial infarction occurred in 1419 (11%) patients while they were receiving a proton pump inhibitor compared with 1341 (8%) who were not receiving a proton pump inhibitor. In multivariate analysis, the hazard ratio for the association between proton pump inhibitor use and death or incident myocardial infarction was 1.37 (95% confidence interval 1.27 to 1.48). Comparable results were seen for secondary outcomes and with other 2C19 inhibitors and with non-2C19 inhibitors. With the self controlled case series design to remove the effect of differences between people, there was no association between proton pump inhibitor use and myocardial infarction, with a rate ratio of 0.75 (0.55 to 1.01). Similarly, with the self controlled case series there was no association with myocardial infarction for other 2C19 inhibitors/non-inhibitors.
conclusionThe lack of a specific association and the discrepancy between findings of the analyses between and within people suggests that the interaction between proton pump inhibitors and clopidogrel is clinically unimportant.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.