The Year in Gastroenterology

David A. Johnson, MD


January 07, 2011

Editor's Note : Dr. Johnson's "Top 10" list is in no particular order.

ACCF/ACG/AHA 2010 Expert Consensus Document on the Concomitant Use of Proton Pump Inhibitors and Thienopyridines: A Focused Update of the ACCF/ACG/AHA 2008 Expert Consensus Document on Reducing the Gastrointestinal Risks of Antiplatelet Therapy and NSAID Use

Abraham NS, Hlatky MA, Antman EM, et al.
Am J Gastroenterol. 2010;105:2533-2549

Summary and Viewpoint

This discussion focuses on the very latest and just released scientific data on the clinical implications of the combined use of proton pump inhibitors (PPIs) and clopidogrel. This consensus document from the American College of Cardiology Foundation (ACCF), the American College of Gastroenterology (ACG), and the American Heart Association (AHA) provides clinicians guidance on the basis of an extensive review of the literature by experts in the field. The latest US Food and Drug Administration (FDA) changes relative to the warnings about combined use of these agents are also highlighted. The bottom line is that the current evidence does not support a clinically significant adverse cardiovascular effect as a result of combining PPIs and clopidogrel. Furthermore, no specific evidence suggests that cardiovascular effects are influenced by any specific PPI. The FDA revised the advisory language on October 27, 2010, to reflect the specific concern about reduced antiplatelet activity of clopidogrel only with omeprazole.[1]



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