PMID- 21106014
OWN - NLM
STAT- MEDLINE
DCOM- 20110310
LR  - 20211020
IS  - 1747-0803 (Electronic)
IS  - 1747-079X (Print)
IS  - 1747-079X (Linking)
VI  - 5
IP  - 6
DP  - 2010 Nov-Dec
TI  - Platelet activity associated with concomitant use of clopidogrel and proton pump 
      inhibitors in children with cardiovascular disease.
PG  - 552-5
LID - 10.1111/j.1747-0803.2010.00461.x [doi]
AB  - CONTEXT: In adults with acute coronary syndrome, decreased platelet inhibition 
      associated with concomitant use of clopidogrel and proton pump inhibitors (PPI) 
      has been reported. OBJECTIVE: To evaluate platelet activity associated with PPI + 
      clopidogrel vs. clopidogrel alone in children enrolled in the Platelet Inhibition 
      in Children On cLOpidogrel (PICOLO) trial of clopidogrel in children with a 
      cardiac condition at risk for arterial thrombosis. DESIGN: Patients 0-24 m 
      randomized to active therapy in the PICOLO trial were included in the present 
      analysis. Platelet aggregation inhibition at baseline and steady state were 
      evaluated in patients taking clopidogrel + PPI vs. clopidogrel only in the 
      overall cohort and sub-group of clopidogrel responders. RESULTS: A total of 49 
      patients were included (44 clopidogrel only, five clopidogrel + PPI); median age 
      38 days (interquartile range [IQR] 17-157 days). The majority of patients in each 
      group had undergone systemic-to-pulmonary artery shunt. Compared with the 
      clopidogrel group, patients in the clopidogrel + PPI group had a trend toward 
      lower percent inhibition of maximum extent of platelet aggregation overall 
      (median 6%, IQR 0-44% vs. 49%, IQR 19-63%, P= 0.09), and a significant reduction 
      in the clopidogrel responders sub-group (median 25%, IQR 3-45% vs. 53%, IQR 
      38-65%, P= 0.04). There was no difference in percent inhibition of rate of 
      platelet aggregation. CONCLUSIONS: Concomitant use of PPI + clopidogrel may be 
      associated with decreased platelet inhibition in children with cardiac disease. 
      Further study in a larger population and assessment of associated clinical 
      outcomes is warranted.
CI  - (c) 2010 Copyright the Authors. Congenital Heart Disease (c) 2010 Wiley Periodicals, 
      Inc.
FAU - Pasquali, Sara K
AU  - Pasquali SK
AD  - Department of Pediatrics, Duke University Medical Center, Duke Clinical Research 
      Institute, Durham, NC 27715, USA. sara.pasquali@duke.edu
FAU - Yow, Eric
AU  - Yow E
FAU - Jennings, Lisa K
AU  - Jennings LK
FAU - Li, Jennifer S
AU  - Li JS
LA  - eng
SI  - ClinicalTrials.gov/NCT00115375
GR  - K08 HL103631/HL/NHLBI NIH HHS/United States
GR  - 1K08HL103631-01/HL/NHLBI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Congenit Heart Dis
JT  - Congenital heart disease
JID - 101256510
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
RN  - A74586SNO7 (Clopidogrel)
RN  - OM90ZUW7M1 (Ticlopidine)
SB  - IM
MH  - Child, Preschool
MH  - Clopidogrel
MH  - Double-Blind Method
MH  - Female
MH  - Heart Defects, Congenital/blood/complications/*drug therapy/surgery
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Platelet Aggregation/*drug effects
MH  - Platelet Aggregation Inhibitors/*therapeutic use
MH  - Platelet Function Tests
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Thrombosis/blood/etiology/*prevention & control
MH  - Ticlopidine/*analogs & derivatives/therapeutic use
MH  - Time Factors
MH  - Treatment Outcome
MH  - United States
PMC - PMC3036010
MID - NIHMS268826
COIS- Conflict of interest: None.
EDAT- 2010/11/26 06:00
MHDA- 2011/03/11 06:00
PMCR- 2011/11/01
CRDT- 2010/11/26 06:00
PHST- 2010/11/26 06:00 [entrez]
PHST- 2010/11/26 06:00 [pubmed]
PHST- 2011/03/11 06:00 [medline]
PHST- 2011/11/01 00:00 [pmc-release]
AID - 10.1111/j.1747-0803.2010.00461.x [doi]
PST - ppublish
SO  - Congenit Heart Dis. 2010 Nov-Dec;5(6):552-5. doi: 
      10.1111/j.1747-0803.2010.00461.x.