PMID- 22727972
OWN - NLM
STAT- MEDLINE
DCOM- 20140422
LR  - 20181202
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 167
IP  - 5
DP  - 2013 Sep 1
TI  - Pantoprazole significantly interferes with antiplatelet effect of clopidogrel: 
      results of a pilot randomized trial.
PG  - 2177-81
LID - S0167-5273(12)00727-9 [pii]
LID - 10.1016/j.ijcard.2012.05.080 [doi]
AB  - BACKGROUND: The CYP2C19*2 polymorphism is significantly associated with residual 
      platelet reactivity (RPR) and maybe a major confounding factor in studies 
      evaluating pharmacological interactions with clopidogrel. OBJECTIVES: We sought 
      to evaluate the influence of a proton pump inhibitor (PPI), pantoprazole, 
      indicated as relatively less influent than other PPIs, on the antiplatelet effect 
      of clopidogrel, considering a stratification of the population for the presence 
      of cytochrome 2C19*2 polymorphism. METHODS: 105 patients with ST elevation 
      myocardial infarction (STEMI), treated with percutaneous coronary angioplasty 
      (PCI) and who received dual antiplatelet therapy, were randomized between 
      pantoprazole (n=54) or ranitidine (n=51). RPR was evaluated by Platelet Function 
      Analyzer-100 (PFA-100) with collagen-epinephrine (CEPI) and collagene-ADP (CADP) 
      cartridges and by light transmitted aggregometry with 10 muM adenosin diphosphate 
      (ADP) and 1mM arachidonic acid (AA), on 5 (T0) and 30 (T1) days after PCI. 
      RESULTS: Demographic, clinical and procedural data and the prevalence of 
      CYP2C19*2 polymorphism were similar between the two groups. Not statistically 
      differences were observed for CEPI-CT and for the maximal aggregation (MA) values 
      with AA stimulus at both times. We observed a significant increase in MA values 
      with ADP in PPI group at T0 (p=0.01) and T1 (p=0.03). At the multiple regression 
      analysis PPI use remained significantly associated with ADP-MA both at T0 
      (p=0.05) and T1 (p=0.03). CONCLUSIONS: This is the first documentation in a 
      randomized trial, after correction for the bias of CYP2C19*2 polymorphism, that 
      pantoprazole increases the ADP-MA in patients treated with dual antiplatelet 
      therapy.
CI  - Copyright (c) 2012 Elsevier Ireland Ltd. All rights reserved.
FAU - Parri, Maria Serena
AU  - Parri MS
AD  - Fondazione Toscana G Monasterio, Ospedale G. Pasquinucci, Massa, Italy. 
      parri@ifc.cnr.it
FAU - Gianetti, Jacopo
AU  - Gianetti J
FAU - Dushpanova, Anar
AU  - Dushpanova A
FAU - Della Pina, Francesca
AU  - Della Pina F
FAU - Saracini, Claudia
AU  - Saracini C
FAU - Marcucci, Rossella
AU  - Marcucci R
FAU - Giusti, Betti
AU  - Giusti B
FAU - Berti, Sergio
AU  - Berti S
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20120622
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
RN  - A74586SNO7 (Clopidogrel)
RN  - D8TST4O562 (Pantoprazole)
RN  - OM90ZUW7M1 (Ticlopidine)
SB  - IM
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles/administration & dosage/*blood
MH  - Aged
MH  - Clopidogrel
MH  - Drug Interactions/physiology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*blood/drug therapy/genetics
MH  - Pantoprazole
MH  - Pilot Projects
MH  - Platelet Aggregation Inhibitors/administration & dosage/*blood
MH  - Platelet Function Tests/methods
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/administration & dosage/*blood
MH  - Ticlopidine/administration & dosage/*analogs & derivatives/blood
OTO - NOTNLM
OT  - CYP2C19*2
OT  - Clopidogrel
OT  - Pantoprazole
EDAT- 2012/06/26 06:00
MHDA- 2014/04/23 06:00
CRDT- 2012/06/26 06:00
PHST- 2011/08/10 00:00 [received]
PHST- 2012/03/19 00:00 [revised]
PHST- 2012/05/27 00:00 [accepted]
PHST- 2012/06/26 06:00 [entrez]
PHST- 2012/06/26 06:00 [pubmed]
PHST- 2014/04/23 06:00 [medline]
AID - S0167-5273(12)00727-9 [pii]
AID - 10.1016/j.ijcard.2012.05.080 [doi]
PST - ppublish
SO  - Int J Cardiol. 2013 Sep 1;167(5):2177-81. doi: 10.1016/j.ijcard.2012.05.080. Epub 
      2012 Jun 22.