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Published on: March 28, 2017
Does CYP2C19 inhibition lead to clopidogrel thrombogenicity?
1Division of Internal Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. matan123@hadassah.org.il
Abstract:
There exits an ongoing debate regarding potential hazards associated with concomitant use of clopidogrel and proton-pump inhibitors. In this manuscript, a meta-analysis of mortality data demonstrates that the mortality prevented by clopidogrel is significantly lower than the mortality caused by clopidogrel and proton-pump inhibitor combination. Given the hazards associated with the combination, abating the positive effect of clopidogrel is not a satisfactory explanation. Thus a hypothesis is proposed, that the combination of proton-pump inhibitors and clopidogrel increases mortality as results of thrombogenic metabolites of clopidogrel, due to inhibition of CYP2C19 by proton-pump inhibitors.
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