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Letter to the Editor: Methodology vs reality - deciphering cardiovascular safety of proton pump inhibitors in dual antiplatelet therapy
Elia De Maria, Arrhythmology Lab, Cardiology Unit, Ramazzini Hospital, Carpi 41012, Modena, Italy
Author contributions: De Maria E wrote and revised the manuscript.
AI contribution statement: AI (Google Gemini) was used for English editing.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Corresponding author: Elia De Maria, MD, Arrhythmology Lab, Cardiology Unit, Ramazzini Hospital, Via Molinari 1, Carpi 41012, Modena, Italy. e.demaria@inwind.it
Received: June 3, 2026
Revised: June 24, 2026
Accepted: July 9, 2026
Published online: July 26, 2026
Processing time: 50 Days and 11.8 Hours
Revised: June 24, 2026
Accepted: July 9, 2026
Published online: July 26, 2026
Processing time: 50 Days and 11.8 Hours
Core Tip
Core Tip: The combination of proton pump inhibitor and dual antiplatelet therapy, in patients undergoing percutaneous coronary intervention, has raised concerns because of the risk of drug-drug interaction potentially reducing clopidogrel efficacy and increasing ischemic risk. A recent meta-analysis, by methodically isolating randomized data from observational biases, proved that the increased cardiovascular risk seen in prior literature was a product of patient-level confounding rather than true biological harm and provided reassurance regarding the safety of combining proton pump inhibitors with clopido