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Plavix Plus Heartburn Drugs May Hike Heart Risk
Date:1/28/2009

Combination might interfere with Plavix's anticlotting ability, experts say

WEDNESDAY, Jan. 28 (HealthDay News) -- People taking the clot-preventing drug Plavix and an acid-reducing proton pump inhibitor medication after a heart attack have a dramatically higher risk of a second heart attack than those taking Plavix alone, a Canadian study finds.

That increased risk could have enormous public health implications. Proton pump inhibitors such as Prilosec and Prevacid are among the most widely prescribed drugs, and Plavix (clopidogrel) is the second highest-selling drug in the world, the researchers said.

The Canadian study of 13,636 people hospitalized with heart attacks between 2002 and 2007 was started as a response to basic science studies showing that the acid-lowering drugs turned off Plavix, said Dr. David N. Juurlink, head of the division of clinical pharmacology and toxicology at Sunnybrook Health Sciences Centre in Toronto.

"We linked prescribing data with hospital data on these more than 13,000 patients prescribed Plavix after a heart attack and found that people on certain proton pump inhibitors had a 40 percent increased risk of a recurrence," said Juurlink, lead author of the report, published online Jan. 28 in the Canadian Medical Association Journal.

It's not the first study to find such a link. A study of 16,000 people reported last year by Medco Health Solutions, a prescription drug provider, found that 39.2 percent of people taking Plavix and a proton pump inhibitor after implant of a stent -- an artery-opening tube -- suffered serious cardiac events, compared with 26.2 percent of those taking Plavix alone. The full study, presented at an American Heart Association meeting, has been submitted to a journal for publication, said Dr. Robert Epstein, chief medical officer at Medco.

The Medco study came about in the same way as the one done in Canada, Epstein said. "We saw the
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