PMID- 30955016
OWN - NLM
STAT- MEDLINE
DCOM- 20200106
LR  - 20200225
IS  - 0975-4466 (Electronic)
IS  - 0256-4947 (Print)
IS  - 0256-4947 (Linking)
VI  - 39
IP  - 2
DP  - 2019 Mar-Apr
TI  - Outcome of stroke patients on clopidogrel plus proton-pump inhibitors: a 
      single-center cohort study.
PG  - 82-86
AB  - BACKGROUND: Recent studies suggest a higher risk of adverse cardiovascular 
      outcome and mortality in patients co-prescribed clopidogrel with proton pump 
      inhibitors (PPI). OBJECTIVE: Investigate the impact of concomitant prescription 
      of clopidogrel and PPI on 30-day unplanned readmission and one-year all-cause 
      mortality. DESIGN: Retrospective longitudinal cohort study. SETTING: Single 
      academic tertiary center. PATIENTS AND METHODS: The study included patients 
      admitted with a diagnosis of ischemic or hemorrhagic stroke between 2010 and 
      2014. Demographic and outcome data were collected and compared for patients on 
      clopidogrel plus PPI vs those on clopidogrel plus H2blockers and those not on 
      clopidogrel. MAIN OUTCOME MEASURES: One-year mortality and 30-day unplanned 
      readmissions were compared among different patient groups using multivariable 
      logistic regression modeling. SAMPLE SIZE: 464 patients. RESULTS: Out of 464 
      patients, 175 (37.7%) were discharged on clopidogrel. The concomitant 
      prescription of clopidogrel and PPI was noted in 107 (24.4%) and clopidogrel and 
      H2 blockers in 36 patients (7.8%). The one-year all-cause mortality in the entire 
      cohort was 22.2%. Patients on clopidogrel plus PPI did not have a higher risk of 
      one-year mortality compared to the non-PPI cohort (6.2% vs. 4.8%, p 0.7). There 
      was a non-significant suggestion of lower one-year mortality in patients on 
      clopidogrel plus PPI vs those not on clopidogrel (6.2% vs. 10.1%, p 0.23). In 
      multivariable logistic regression, the use of clopidogrel plus PPI did not 
      predict higher one-year mortality (odds ratio 0.6, P=0.6). The risk of unplanned 
      30-day readmission was lower in those with clop-idogrel plus PPI (odds ratio 0.6, 
      P=.03). CONCLUSION: The use of clopidogrel plus PPI resulted in lower readmission 
      rates and was not associated with higher mortality compared with the non-PPI 
      cohorts. LIMITATIONS: Single center study, not generalizable. Given the 
      retrospective nature of this study, we did not collect data on duration of 
      treatments or patient compliance. CONFLICT OF INTEREST: None.
FAU - Alghamdi, Rahaf A
AU  - Alghamdi RA
FAU - Marzoughi, Sina
AU  - Marzoughi S
FAU - Alghamdi, Muath S
AU  - Alghamdi MS
FAU - Alghamdi, Aisha
AU  - Alghamdi A
FAU - Almekhlafib, Mohammed
AU  - Almekhlafib M
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - Saudi Arabia
TA  - Ann Saudi Med
JT  - Annals of Saudi medicine
JID - 8507355
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
RN  - A74586SNO7 (Clopidogrel)
SB  - IM
MH  - Aged
MH  - Clopidogrel/*administration & dosage
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Logistic Models
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Patient Readmission/statistics & numerical data
MH  - Platelet Aggregation Inhibitors/*administration & dosage
MH  - Proton Pump Inhibitors/*administration & dosage
MH  - Retrospective Studies
MH  - Stroke/*drug therapy/*mortality
MH  - Treatment Outcome
PMC - PMC6464665
COIS- CONFLICT OF INTEREST: None.
EDAT- 2019/04/08 06:00
MHDA- 2020/01/07 06:00
PMCR- 2019/03/01
CRDT- 2019/04/08 06:00
PHST- 2019/04/08 06:00 [entrez]
PHST- 2019/04/08 06:00 [pubmed]
PHST- 2020/01/07 06:00 [medline]
PHST- 2019/03/01 00:00 [pmc-release]
AID - asm-2-82 [pii]
AID - 10.5144/0256-4947.2019.82 [doi]
PST - ppublish
SO  - Ann Saudi Med. 2019 Mar-Apr;39(2):82-86. doi: 10.5144/0256-4947.2019.82.