Increased Risk of Ischemic Events in Patients With Stroke Treated With Clopidogrel and a P-CAB or PPI - PubMed
4 hours ago
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- #clopidogrel
- Increased risk of ischemic events in stroke patients treated with clopidogrel and P-CAB or PPI.
- Study based on Korean National Health Insurance Service database (2016-2022) covering 51.4 million individuals.
- 62.5% of 65,180 stroke patients received clopidogrel; 16.4% clopidogrel alone, 1.4% clopidogrel+P-CAB, 21.6% clopidogrel+PPI.
- Higher risk of major adverse cardiovascular events (MACE) and stroke recurrence with clopidogrel+P-CAB (HR 2.40 and 2.64 respectively) compared to clopidogrel alone.
- Clopidogrel+PPI also showed increased risk of MACE (HR 1.38) and stroke recurrence (HR 1.41).
- Esomeprazole (a PPI) associated with higher risk of MACE (HR 1.46) and stroke recurrence (HR 1.50).
- No significant difference in gastrointestinal bleeding among the cohorts.
- P-CABs or PPIs should be prescribed cautiously with clopidogrel in stroke patients.