Combining Plavix and Heart Burn Drugs for Stent Patients May Increase Risk of Heart Attack, Stroke

According to new research presented yesterday at an American Heart Association conference, cardiac stent patients who are prescribed Plavix together with a heart burn drug like Nexium, may face an increased risk of heart attacks, strokes and other potentially life-threatening events.

 
Heart stents are small wire-mesh tubes used to prop open previously clogged arteries that have been cleared of plaque.

Following most stent procedures, patients are prescribed Plavix, which is a blood thinner, to reduce the risk of a blood clot forming at the site of the stent. However, Plavix side effects have been associated with an increased risk of ulcers and gastrointestinal bleeds, so many doctors also prescribe Nexium or another anti-ulcer drug at the same time.

According to the study presented at the AHA conference in New Orleans, Nexium and other drugs from a family of medications known as proton pump inhibitors, may actually inhibit the impact of Plavix, by interfering with a liver enzyme needed to process the blood thinner.

Researchers evaluated data from more than 16,000 patients in a database maintained by a pharmacy benefits manager between 2005 and 2006, and found that the use of proton pump inhibitors along with Plavix in heart stent patients was associated with a 50% increased risk for heart attacks, strokes, bypass surgery and heart-related death.

The study raises serious concerns about what medications and treatments should be recommended for heart patients.

Most doctors implanting heart stents in recent years have transitioned to using newer drug eluting or medicated stents, which contain a drug coating that helps prevent the buildup of scar tissue inside the artery. This reduces the risk of another blockage caused by the scar tissue.

However, prior studies have found that this drug coating may increases the risk of a blood clot developing at the site of the stent. This has required doctors to recommend that most patients receiving a heart stent need to stay on Plavix indefinitely, which could substantially increase their risk of ulcers and GI bleeds if they are unable to take Nexium or another heart burn medication concurrently.