[Coronary stent thrombosis in concurrent clopidogrel and proton pump inhibitor therapy]

Combined treatment with clopidogrel (CLO) and proton pump inhibitors (PPIs) following coronary stent implantation is often used. CLO as well as PPIs are metabolised by cytochrome P450 isoenzymes, which could theoretically reduce the effect of clopidogrel. Lately, the possibility that such combined therapy may cause an increase in the risk of stent thrombosis has given rise to concern. A review of the literature revealed an attenuation of the antiplatelet effects of clopidogrel in the presence of a PPI in vitro, but evidence on the clinical importance of this finding is conflicting.