Clinical reevaluation of concomitant usage of anti-platelet agents and proton pump inhibitors

Anti-platelet agents are proved to be effective for primary and secondary prevention of cardiovascular event, but they will cause peptic ulcer disease with bleeding, leading to morbidity and mortality. Therefore, proton pump inhibitors are usually co-prescribed for preventing ulcer bleeding. However, a substantial of recent reports raises concerns on what drug-drug interaction of thienopyridine and proton pump inhibitors may translate into clinical outcomes based on pharmacokinetics evidences. Nevertheless, the effect of co-treatment of Clopidogrel and a proton pump inhibitor on cardiovascular outcomes has been inconsistent and conflicting. A newly published clinical guideline provides some useful recommendations to deal with this challenging clinical situation.