Pantoprazole Does Not Reduce the Antiplatelet Effect of Clopidogrel: A Randomized Controlled Trial in Korea
Gut and Liver
;
: 504-511, 2017.
Artigo
em Inglês
| WPRIM
| ID: wpr-88946
ABSTRACT
BACKGROUND/AIMS:
Concerns that proton pump inhibitors (PPIs) diminish the efficacy of clopidogrel could hamper the appropriate prescription of PPIs. We evaluated the influence of pantoprazole on the antiplatelet effect of clopidogrel compared with ranitidine, which is regarded as safe, after stratification of the population according to the presence of a cytochrome (CYP) 2C19 polymorphism in Korea.METHODS:
Forty patients who underwent dual antiplatelet therapy were randomized to receive pantoprazole (n=20) or ranitidine (n=20). Platelet aggregation was evaluated by impedance aggregometry at baseline (D0) and 8 days after acid-lowering treatments (D9). CYP2C19 was genotyped by polymerase chain reaction restriction fragment length polymorphism.RESULTS:
After co-treatment, the percentage of clopidogrel low-response was 11.1% (2/18) in the pantoprazole group and 10.5% (2/19) in the ranitidine group (p=0.954). The impedance values with adenosine diphosphate stimulus after acid-lowering treatments did not significantly differ between the two groups. In a multiple regression analysis, only ST-elevation myocardial infarction was marginally associated with a reduced antiplatelet effect (odds ratio, 12.07; 95% confidence interval, 0.84 to 173.78). However, pantoprazole use did not affect the antiplatelet effect after correction for the CYP2C19 polymorphism.CONCLUSIONS:
This study showed that pantoprazole does not increase platelet aggregation in patients receiving dual antiplatelet therapy (ClinicalTrials.gov number NCT02733640).
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Ranitidina
/
Polimorfismo de Fragmento de Restrição
/
Difosfato de Adenosina
/
Agregação Plaquetária
/
Reação em Cadeia da Polimerase
/
Impedância Elétrica
/
Citocromos
/
Interações Medicamentosas
/
Inibidores da Bomba de Prótons
/
Prescrições
Tipo de estudo:
Ensaio Clínico Controlado
Limite:
Humanos
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
Gut and Liver
Ano de publicação:
2017
Tipo de documento:
Artigo
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