October 8th, 2010
Podcast 104: Reassurance on clopidogrel and omeprazole.
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We welcome Dr. Danielle Bowen Scheurer to our conversational team this week She’s a hospitalist at the Medical University of South Carolina and an associate editor of Physician’s First Watch.
Our guest is Dr. Deepak Bhatt, who has just published some reassuring results on omeprazole’s putative interaction with clopidogrel in the New England Journal of Medicine.
If you’d like to suggest topics or ways to improve this podcast, we’re all ears. Drop me a line at jelia@jwatch.org — thank you.
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2 Responses to “Podcast 104: Reassurance on clopidogrel and omeprazole.”
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The COGENT study was flawed. The patients received either clopidogrel and PPI or clopidogrel, but both received enteric coated aspirin of unknown strength. Clopidogrel and PPI is still suspect since aspirin was used. A real study would have tested clopidogrel and PPI without aspirin. All the Bhatt study proved is that aspirin is your best bet.
Dr. Bhatt’s important study is well-designed and executed. I would note, however, that some other investigators have reported opposing results. One recent study, in particular, conducted by Charlot et al., 2010, and published in the Annals of Internal Medicine, involved an initial sample of over 24,000 patients. The study showed that PPIs do increase the risk of adverse cardiovascular events during the first year following MI.