Document Detail

Pantoprazole does not influence the antiplatelet effect of clopidogrel-a whole blood aggregometry study after coronary stenting.
MedLine Citation:
PMID:  20410834     Owner:  NLM     Status:  MEDLINE    
Recent attention has been drawn to a potential drug-drug interaction observed between clopidogrel and proton pump inhibitors (PPIs). However, this potential interaction may not be a class effect of PPIs. We investigated if pantoprazole, which has a different metabolism than omeprazole, diminishes the effectiveness of clopidogrel. Our study included 336 patients (mean age 64.6 years; 106 women) 48 hours after percutaneous coronary stent implantation with a loading dose of 600 mg clopidogrel hydrogensulfate and 500 mg aspirin, followed by 75 mg clopidogrel and 100 mg aspirin daily. Whereas 188 patients (59 women) were not given any PPI comedication, 122 patients received pantoprazole and 26 either omeprazole or esomeprazole. The platelet aggregation followed by impedance aggregometry (in Ohm) was induced by 5 mmol/L adenosine diphosphate. The percentage of clopidogrel low-response (CLR) was similar between the non-PPI group [2.75 Ohm (confidence interval, CI: 2.25-3.26); 21.9% CLR] and the pantoprazole group [2.33 Ohm (CI: 1.79-2.87); 16.4% CLR] but higher in patients treated with omeprazole/esomeprazole (3.00 Ohm (CI: 1.49-4.51); 30.8% CLR). Multivariate regression analysis reveals that the risk of CLR in the pantoprazole comedication group was not increased compared with the group without any PPI [odds ratio 0.59 (CI: 0.31-1.13) 0.11]. Our data suggest that pantoprazole does not diminish the antiplatelet effectiveness of clopidogrel early after coronary stenting. Therefore, the use of pantoprazole seems preferable in patients treated with clopidogrel when a concomitant medication with a PPI is indicated.
Horst Neubauer; Andreas Engelhardt; Jan C Krüger; Sebastian Lask; Jan Börgel; Andreas Mügge; Heinz G Endres
Related Documents :
11303704 - Long-term angiographic follow-up after successful repeat balloon angioplasty for in-ste...
19147604 - Mortality following placement of drug-eluting and bare-metal stents for st-segment elev...
11044414 - Treatment of aortocoronary vein graft lesions with membrane-covered stents: a multicent...
10474794 - One-year clinical follow-up with the serpentine balloon expandable stent: report of the...
22392354 - Desarda versus lichtenstein technique for primary inguinal hernia treatment: 3-year res...
2559664 - Treatment of pigmented villonodular synovitis of the knee with yttrium-90 silicate: pro...
Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular pharmacology     Volume:  56     ISSN:  1533-4023     ISO Abbreviation:  J. Cardiovasc. Pharmacol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-20     Completed Date:  2010-11-02     Revised Date:  2013-06-04    
Medline Journal Info:
Nlm Unique ID:  7902492     Medline TA:  J Cardiovasc Pharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  91-7     Citation Subset:  IM    
Ruhr University Bochum, Cardiovascular Center, St. Josef-Hospital, Bochum, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
2-Pyridinylmethylsulfinylbenzimidazoles / metabolism,  pharmacology*
Angioplasty, Balloon, Coronary / methods
Aspirin / therapeutic use
Coronary Artery Disease / therapy
Drug Interactions
Esomeprazole Sodium
Middle Aged
Multivariate Analysis
Omeprazole / metabolism,  pharmacology
Platelet Aggregation / drug effects
Platelet Aggregation Inhibitors / metabolism,  pharmacology*
Platelet Function Tests
Prospective Studies
Proton Pump Inhibitors / metabolism,  pharmacology*
Regression Analysis
Ticlopidine / analogs & derivatives*,  metabolism,  pharmacology
Reg. No./Substance:
0/2-Pyridinylmethylsulfinylbenzimidazoles; 0/Platelet Aggregation Inhibitors; 0/Proton Pump Inhibitors; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; 73590-58-6/Omeprazole; A74586SNO7/clopidogrel; D8TST4O562/pantoprazole; L2C9GWQ43H/Esomeprazole Sodium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Pharmacological Inhibition of Cathepsin S Decreases Atherosclerotic Lesions in Apoe-/- Mice.
Next Document:  In-treatment midwall and endocardial fractional shortening predict cardiovascular outcome in hyperte...