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SCAI Statement on 'A National Study of the Effect of Individual Proton Pump Inhibitors on Cardiovascular Outcomes in Patients Treated with Clopidogrel Following Coronary Stenting: The Clopidogrel Medco Outcomes Study'
Date:5/6/2009

pantoprazole (Protonix), esomeprazole (Nexium), omeprazole (Prilosec), and lansoprazole (Prevacid). It did not review outcomes in patients taking any of the newer PPIs, such as rabeprazole (Aciphex) or dexlansoprazole (Kapidex). Patients in the study took PPIs for an average of nine months.

SCAI believes more research is needed on this topic. However, given the thousands of patients who receive stents each year, coupled with the significant risks demonstrated in this study, SCAI recommends the use of alternative medications for GI symptoms in patients with stents when appropriate. Other effective treatments for heartburn and ulcers include histaminergic (H2) blockers (Zantac, Tagamet) or antacids. In some patients the use of PPIs may still be warranted based on the patient's medical problems and should be taken at the direction of the patient's cardiologist, gastroenterologist or primary physician.

Importantly, patients should never stop taking any prescribed medication without first discussing with their doctor. Guidelines authored by SCAI and other cardiovascular organizations recommend dual-antiplatelet therapy for no less than one year following stent implantation. Clinical trials have shown this drug regimen effectively prevents blood clots that can lead to rare but potentially life-threatening cardiac events.


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