PMID- 19081411
OWN - NLM
STAT- MEDLINE
DCOM- 20090122
LR  - 20181201
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 157
IP  - 1
DP  - 2009 Jan
TI  - Effects of pantoprazole and esomeprazole on platelet inhibition by clopidogrel.
PG  - 148.e1-5
LID - 10.1016/j.ahj.2008.09.017 [doi]
AB  - BACKGROUND: Clopidogrel is activated by CYP2C19, which also metabolizes proton 
      pump inhibitors (PPI). As proton pump inhibitors are metabolized to varying 
      degrees by CYP2C19, we hypothesized that the reported negative 
      omeprazole-clopidogrel drug interaction may not be a class effect. METHODS: 
      Responsiveness to clopidogrel was assessed by the vasodilator-stimulated 
      phosphoprotein phosphorylation (VASP) assay and aggregometry (Multiplate 
      Analyzer) in 300 patients with coronary artery disease (CAD) undergoing 
      percutaneous coronary intervention (PCI). RESULTS: The mean platelet reactivity 
      index (PRI, assessed by the VASP assay) was nearly the same in patients with (n = 
      226; PRI = 51%) or without PPI treatment (n = 74; PRI = 49%; P = .724). Likewise, 
      the adenosine diphosphate-induced platelet aggregation did not differ 
      significantly between patients with or without PPI treatment (45 vs. 41 U; P = 
      .619). Similarly, there was no difference in the PRI or the adenosine 
      diphosphate-induced platelet aggregation between patients with pantoprazole (n = 
      152; PRI = 50%; aggregation = 47 U), esomeprazole (n = 74; PRI = 54%; aggregation 
      = 42 U), or without PPI (n = 74; PRI = 49%; aggregation = 41 U; P = .382). 
      CONCLUSION: In contrast to the reported negative omeprazole-clopidogrel drug 
      interaction, the intake of pantoprazole or esomeprazole is not associated with 
      impaired response to clopidogrel.
FAU - Siller-Matula, Jolanta M
AU  - Siller-Matula JM
AD  - Department of Clinical Pharmacology, Medical University of Vienna, Vienna, 
      Austria.
FAU - Spiel, Alexander O
AU  - Spiel AO
FAU - Lang, Irene M
AU  - Lang IM
FAU - Kreiner, Gerhard
AU  - Kreiner G
FAU - Christ, Guenter
AU  - Christ G
FAU - Jilma, Bernd
AU  - Jilma B
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20081106
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
RN  - A74586SNO7 (Clopidogrel)
RN  - D8TST4O562 (Pantoprazole)
RN  - KG60484QX9 (Omeprazole)
RN  - N3PA6559FT (Esomeprazole)
RN  - OM90ZUW7M1 (Ticlopidine)
SB  - IM
CIN - Am Heart J. 2009 Jun;157(6):e43; author reply e45. PMID: 19464402
CIN - Am Heart J. 2009 Jul;158(1):e7; author reply e9. PMID: 19540383
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles/*pharmacology
MH  - Aged
MH  - Blood Platelets/*drug effects/*physiology
MH  - Clopidogrel
MH  - Drug Interactions
MH  - Esomeprazole
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Omeprazole/*pharmacology
MH  - Pantoprazole
MH  - Platelet Aggregation Inhibitors/*pharmacology
MH  - Proton Pump Inhibitors/*pharmacology
MH  - Ticlopidine/*analogs & derivatives/pharmacology
EDAT- 2008/12/17 09:00
MHDA- 2009/01/23 09:00
CRDT- 2008/12/17 09:00
PHST- 2008/08/24 00:00 [received]
PHST- 2008/09/25 00:00 [accepted]
PHST- 2008/12/17 09:00 [entrez]
PHST- 2008/12/17 09:00 [pubmed]
PHST- 2009/01/23 09:00 [medline]
AID - S0002-8703(08)00822-3 [pii]
AID - 10.1016/j.ahj.2008.09.017 [doi]
PST - ppublish
SO  - Am Heart J. 2009 Jan;157(1):148.e1-5. doi: 10.1016/j.ahj.2008.09.017. Epub 2008 
      Nov 6.