A new meta-analysis of data regarding the clinical significance of the reported increased risks of bleeding when using clopidogrel in combination with PPIs was published in Open Heart. Data from patients on clopidogrel with and without PPIs was analysed. A total of 39 studies with 214 851 patients were analysed.

The results suggest that PPIs are a marker of increased cardiovascular risk in patients taking clopidogrel, rather than a direct cause of worse outcomes. The pharmacodynamic interaction between PPIs and clopidogrel most likely has no clinical significance. Furthermore, PPIs have the potential to decrease gastrointestinal bleeding in clopidogrel users.

See the full meta-analysis.