Letter by Guijarro Regarding Article, “Cerebrovascular Outcomes With Proton Pump Inhibitors and Thienopyridines: A Systematic Review and Meta-Analysis”
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To the Editor:
A recent meta-analysis suggests that the use of proton pump inhibitors (PPI) may increase the risk for stroke in patients receiving antithrombotic treatment with thienopyridines.1 However, among the 22 trials included in the meta-analysis, only 2 were specifically designed as randomized controlled trials (RCT) evaluating the interaction of PPI and thienopyridines.2,3 In both trials, patients receiving clopidogrel were randomly allocated to receive either a PPI (esomeprazole or omeprazole) or placebo. In both trials, PPI therapy was associated with a …