The Safety of Proton Pump Inhibitors and Clopidogrel in Patients After Stroke
作者： David N. Juurlink , Tara Gomes , Muhammad M. Mamdani , David J. Gladstone , Moira K. Kapral
DOI: 10.1161/STROKEAHA.110.596643
关键词: Medicine 、 In patient 、 Pharmacoepidemiology 、 Vascular disease 、 Clopidogrel 、 Surgery 、 Central nervous system disease 、 Stroke 、 Internal medicine 、 Cohort 、 Drug interaction
摘要: Background and Purpose—Evidence suggests that some proton pump inhibitors can attenuate the antiplatelet effect of clopidogrel. The significance this potential drug interaction in patients with cerebrovascular disease is unknown. Methods—We conducted a nested case–control study all Ontario residents aged ≥66 years newly treated clopidogrel after stroke between April 1, 2002, September 30, 2008. In primary analysis, case were those readmitted for stroke, secondary analysis examined all-cause mortality. For each case, up to 4 event-free control subjects matched on age, gender, outcome type (stroke or transient ischemic attack). Exposure was categorized as current (within 60 days), previous (61 180 remote (181 365 days). Results—Among 2765 entering cohort, we identified 118 cases 472 subjects. After multivariable adjustment, use not associ...
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