Estudio observacional sobre la influencia de los inhibidores de la bomba de protones en la incidencia de episodios cardiovasculares en pacientes tratados con clopidogrel

Abstract

Objective

To analyze the ratio of hospitalizations (NH) due to cardiovascular events (CE) and mortality in patients treated with clopidogrel in association or not to a proton pump inhibitors (PPI).

Material and methods

A retrospective cohort study was performed. Patients who were taking clopidogrel and who belonged to four health centers in PC in two different health areas from Galicia (the data was obtained of the health care homologation program of prescriptions from the Sub-Department of Pharmacy) were selected. The study period included January 2007-March 2009. Computerized medical records and records in paper format were analyzed to determine the prescription of PPI and whether the patient had any NH as a result of CE (AMI, ACS, stroke, TIA, bypass, stroke and/or peripheral artery disease). The data were analyzed using the SPSS statistical program and a descriptive and statistical analysis was performed (CHI-square test and ANOVA test).

Results

A total of 304 patients who fulfilled the inclusion criteria (65.5% male and 34.5% women) were enrolled. A total of 58.6% of the patients were treated with clopidogrel and a PPI. Of these 58.6% required hospitalization due to a CE versus 14.3%, when no PPI was associated. This means a 2.1 times higher risk of suffering a NH. Omeprazole was the PPI most used (73.65%).

Conclusions

The results obtained indicate a probable interaction between PPI and clopidogrel, it not being possible to establish its clinical importance. This does not imply that it may have serious repercussions for the health of the patients.