The clinical endpoints were new rehospitalization for acute coronary syndrome re-ACStarget vessel revascularization TVRand cardiac death. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.
This study aimed to assess if proton pump inhibitors PPIs may reduce the effectiveness of clopidogrel, than H2 antagonist anti-H2 in order to determine rehospitalization for acute coronary syndrome re-ACStarget vessel revascularization TVR and cardiac death.
The isoenzyme CYP2C19 plays an important role in the clopidogrel activation. This median duration was imputed for all individual prescriptions where duration was not recorded. Esomeprazole, pantoprazole, omeprazole, lansoprazole. For our analysis we had to make an assumption about likely exposure status for all drugs during apparent gaps in prescribing records.
Abstract This study aimed to assess if proton pump inhibitors PPIs may reduce the effectiveness of clopidogrel, than H2 antagonist anti-H2 in order to determine rehospitalization for acute coronary syndrome re-ACStarget vessel revascularization TVR and cardiac death. Our study carries the inherent limitations of an observational study, including failure to account for all confounding variables that could have contributed to the observed findings.
Impact of CYP2C19 variant genotypes on clinical efficacy of antiplatelet treatment with clopidogrel: Approximatelypercutaneous coronary intervention PCI procedures to alleviate acute coronary syndrome ACS ischemia are performed in the United States each year. Ann Intern Med ; These observed associations with exposures and outcomes that would not be expected from the theoretical drug interaction suggest these results could be driven by important differences between proton pump inhibitor users and non-users rather than showing a causal association.
Such confounding can be difficult to overcome in non-randomised studies of drug use.
Nonetheless, some studies have preferentially identified a harmful effect of strong CYP 2C19 inhibitors but not weak inhibitors, a finding that is not readily explained. Overall, patient populations had similar proportions of comorbidities, including hypertension, hyperlipidemia, diabetes mellitus, and smoking status Table 2.
Comparison with other studies These results need to be viewed in the context of other studies examining this drug interaction.
Clopidogrel and proton pump inhibitors - possible interaction. The obvious concern and serious complication with prolonged DAT is a bleeding of the gastrointestinal tract. Aliment Pharmacol Ther ; IJD conceived the study, analysed the data, interpreted the results, and wrote the paper. Currently Medsafe does not have sufficient information about interactions between clopidogrel and PPIs other than omeprazole and esomeprazole to be able to make specific recommendations.
During follow-up, use of proton pump inhibitor was sporadic in some patients and started later on in others. Preferred reporting items for systematic reviews and meta-analyses: The first was a retrospective cohort study using automated data from 20, patients hospitalized for myocardial infarction, coronary artery revascularization or unstable angina.