We thank Chua and colleagues for their interest in our article.1 Our study is 1 of 5 published observational cohort studies1- 5 to evaluate the effect of concomitant PPI use in patients receiving clopidogrel therapy.2- 5 Two of these studies (our study1 and Ho et al2) found that PPI use in combination with clopidogrel was associated with increased risk of cardiovascular events compared with clopidogrel alone. Another study by Rassen et al,3 while not meeting formal criteria for statistical significance, also suggested an increased risk of myocardial infarction or death in patients with concomitant use of PPIs with clopidogrel (adjusted rate ratio, 1.22; 95% confidence interval, 0.99-1.51).
Stockl KM, Harada ASM, Solow BK, Addiego JE, Ramsey S. Conflicting Evidence Surrounding the Clopidogrel and Proton Pump Inhibitor Drug Interaction—Reply. Arch Intern Med. 2010;170(16):1507-1508. doi:10.1001/archinternmed.2010.300