In Reply: We agree with Drs Chae and Kim that some PPIs may not be associated with attenuation of the benefits of clopidogrel. In our study, the majority of patients were prescribed omeprazole and, to a smaller extent, rabeprazole. Thus, the results are primarily referable to these agents.
Chae and Kim cite the ACCF/ACG/AHA consensus statement on reducing gastrointestinal risks of antiplatelet therapy and NSAID use. This statement recommended that patients taking dual antiplatelet therapy should be prescribed a PPI medication in the presence of specific risk factors.1
Ho PM, Rumsfeld JS, Wang L. Adverse Outcomes Associated With Use of Proton Pump Inhibitors and Clopidogrel—Reply. JAMA. 2009;302(1):29-31. doi:10.1001/jama.2009.900