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Proton Pump Inhibitors after a Heart Attack May be Risky

Sep 17, 2010 | Parker Waichman LLP

New research has indicated that proton pump inhibitors might not be the best choice for patients who have recently suffered a heart attack. According to an report on, a medical Web site out of the United Kingdom, taking the popular heartburn drugs in the months after a heart attack could raise the risks of another cardiovascular event by as much as a third.

Proton pump inhibitors, available by prescription and over-the-counter (OTC), work by reducing the amount of acid in the stomach, and are approved to treat conditions such as gastroesophageal reflux disease (GERD), stomach and small intestine ulcers, and inflammation of the esophagus. Prescription versions of the drugs include Nexium, Dexilant, Prilosec, Zegerid, Prevacid, Protonix, and Aciphex. OTC brands include Prilosec OTC, Zegerid OTC and Prevacid 24HR.

According to the report, a new study of over 56,000 Danish patients discharged after a heart attack found that those who had at least one prescription for a proton pump inhibitor (PPI) had a 29 percent increased risk of cardiovascular death or rehospitalization for a heart attack or stroke in the 30 days after discharge compared with those who did not receive such a drug. The study is published in the Annals of Internal Medicine.

This is not the first time concerns have been raised about possible risks proton pump inhibitors may pose to heart patients. Just this past November, we reported that the US Food & Drug Administration (FDA) had warned that patients taking the anti-clotting medication Plavix (clopidogrel) should avoid proton pump inhibitors because of data indicating the heartburn drugs could interfere with the effectiveness of Plavix.

But according to the report, the risk for additional cardiac events in this latest study was exactly the same for those prescribed a proton pump inhibitor and Plavix, compared to those not prescribed a proton pump inhibitor.

Lead author Dr Mette Charlot, a cardiologist at Copenhagen University hospital, concluded: “These results seem to refute concerns about increased risk for ischemic events during concomitant PPI and clopidogrel therapy.”

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