Frequency and Outcomes of Concomitant Use of Proton Pump Inhibitors and Clopidogrel after Hospital Discharge

Objective. To assess the frequency of concomitant use of proton pump inhibitors (PPI) in patients treated with clopidogrel, and the potential impact of this use on cardiovascular events. Method. Three-month prospective observational study. All patients taking clopidogrel who were admitted to the study hospital were included in the study. They were split into categories based on whether they had taken the drug concomitantly with PPI upon admission, upon discharge or during follow-up, or if they had not taken the two drugs together at all. Any post-discharge readmissions for cardiovascular events in the three months following the original admission were also recorded. Results. A total of 134 patients were included in the study. Only 26 patients (19,6%) did not take any PPI. Among 14 patients (10.5%) readmitted because of a cardiovascular event, 13 were taking clopidogrel concomitantly with a PPI (not statistically significant). Most of the readmitted patients presented other risk factors potentially related with cardiovascular events. Conclusion. This study underlines a high concomitant use of PPI with clopidogrel, with no evidence of an increasing risk of readmission due to cardiovascular event potentially related to a drug-drug interaction between these drugs. The study did not identify any readmission related to a gastro-intestinal complication

Inflammatory and Oxidative Stress Markers Related to Adherence to the Mediterranean Diet in Patients with Metabolic Syndrome

Metabolic syndrome (MetS) is characterized by increased pro-oxidative stress and a pro-inflammatory state. Several studies emphasized the protective effect of the Mediterranean dietary pattern (MDP). To assess the oxidative and inflammatory state according to the adherence to MDP using biomarkers in patients with MetS. Antioxidant and pro-inflammatory biomarkers were determined in plasma, peripheral blood mononuclear cells (PBMCs), and neutrophils of adults (aged 55–75 years old; 60% women) with MetS living in Mallorca (Spain). Anthropometrics, dietary intake by a validated semi-quantitative 143-item food frequency questionnaire, and a Dietary Inflammatory Index were measured. Patients with low adherence to MDP showed higher levels of glycated haemoglobin A1c and triglycerides, and lower levels of HDL cholesterol. Plasma levels of interleukin-1β, IL-6, IL-15, tumour necrosis factor α, xanthine oxidase, and ghrelin, and activities of superoxide dismutase, and myeloperoxidase were higher in subjects with low adherence to the MDP. Reactive oxygen species production in PBMCs and neutrophils stimulated with lipopolysaccharide was higher in participants with low adherence to the MDP. Patients with MetS and higher adherence to the MDP showed less altered anthropometric parameters, blood biochemical profile, and better oxidative and inflammatory status