Document Detail


The impact of treatment with omeprazole on the effectiveness of clopidogrel drug therapy during the first year after successful coronary stenting.
MedLine Citation:
PMID:  20151060     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Because clopidogrel is converted to its active metabolite by P450 isoenzymes, which are also involved in the metabolism of omeprazole, there is concern regarding whether the action of clopidogrel would be reduced in patients also taking omeprazole.
OBJECTIVE: To evaluate the impact of omeprazole administration on the effectiveness of clopidogrel drug therapy during the first year following successful coronary stenting (CS).
METHODS: A total of 588 consecutive patients who underwent successful CS for stable or unstable coronary artery disease were studied. Patients were classified into those who were treated (group A, n=340) or not treated (group B, n=248) with omeprazole for seven or more consecutive days during the entire observation period. The composite of cardiac death or rehospitalization for nonfatal myocardial infarction during the first year was the prespecified primary study end point.
RESULTS: Baseline characteristics, and dual clopidogrel and acetylsalicylic acid drug therapy were well balanced between the study groups. By one year, the primary end point was reached by 58 (9.9%) patients, including 20 (3.4%) who died due to cardiac reasons and 38 (6.5%) who were rehospitalized because of a nonfatal myocardial infarction. Patients in groups A and B, respectively, were at similar risk of the primary composite end point (10% versus 9.7%, hazard ratio 1.1 [95% CI 0.6 to 1.8]; P=0.89).
CONCLUSIONS: According to the results of the present study, treatment with omeprazole had no impact on the clinical efficacy of clopidogrel drug therapy during the first year after successful CS.
Authors:
Michael N Zairis; George Z Tsiaousis; Nikolaos G Patsourakos; Anastassios Theodossis Georgilas; Constantinos F Kontos; Evdokia N Adamopoulou; Konstantinos Vogiatzidis; Spyros K Argyrakis; Constantine N Fakiolas; Stefanos G Foussas
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  26     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-12     Completed Date:  2010-03-11     Revised Date:  2011-07-22    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e54-7     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Tzanio Hospital, Piraeus, Greece. zairis66@otenet.gr
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Angina, Unstable / diagnosis,  physiopathology,  surgery*
Angioplasty, Balloon, Coronary / methods*
Cause of Death
Drug Therapy, Combination
Enzyme Inhibitors / administration & dosage*
Female
Follow-Up Studies
Greece / epidemiology
Humans
Incidence
Male
Middle Aged
Myocardial Infarction / diagnosis,  mortality,  prevention & control*
Omeprazole / administration & dosage*
Patient Readmission / statistics & numerical data
Platelet Aggregation Inhibitors / therapeutic use
Prospective Studies
Stents*
Ticlopidine / analogs & derivatives*,  therapeutic use
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Enzyme Inhibitors; 0/Platelet Aggregation Inhibitors; 55142-85-3/Ticlopidine; 73590-58-6/Omeprazole; 90055-48-4/clopidogrel
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