Proton-Pump Inhibitors Are Associated With Increased Cardiovascular Risk Independent of Clopidogrel Use A Nationwide Cohort Study

Background: Controversy remains on whether the dual use of clopidogrel and proton-pump inhibitors (PPIs) affects clinical effi-cacy of clopidogrel. Objective: To examine the risk for adverse cardiovascular out-comes related to concomitant use of PPIs and clopidogrel com-pared with that of PPIs alone in adults hospitalized for myo-cardial infarction. Design: A nationwide cohort study based on linked administrative registry data. Setting: All hospitals in Denmark. Patients: All patients discharged after first-time myocardial infarc-tion from 2000 to 2006. Measurements: The primary outcome was a composite of rehos-pitalization for myocardial infarction or stroke or cardiovascular death. Patients were examined at several assembly time points