PMID- 27792656
OWN - NLM
STAT- MEDLINE
DCOM- 20171219
LR  - 20181202
IS  - 2047-9980 (Electronic)
IS  - 2047-9980 (Linking)
VI  - 5
IP  - 10
DP  - 2016 Oct 21
TI  - Impact of Proton Pump Inhibitor Use on the Comparative Effectiveness and Safety 
      of Prasugrel Versus Clopidogrel: Insights From the Treatment With Adenosine 
      Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns 
      and Events After Acute Coronary Syndrome (TRANSLATE-ACS) Study.
LID - e003824
AB  - BACKGROUND: Proton pump inhibitors (PPIs) reduce gastrointestinal bleeding events 
      but may alter clopidogrel metabolism. We sought to understand the comparative 
      effectiveness and safety of prasugrel versus clopidogrel in the context of proton 
      pump inhibitor (PPI) use. METHODS AND RESULTS: Using data on 11 955 acute 
      myocardial infarction (MI) patients treated with percutaneous coronary 
      intervention at 233 hospitals and enrolled in the TRANSLATE-ACS study, we 
      compared whether discharge PPI use altered the association of 1-year adjusted 
      risks of major adverse cardiovascular events (MACE; death, MI, stroke, or 
      unplanned revascularization) and Global Use of Strategies To Open Occluded 
      Arteries (GUSTO) moderate/severe bleeding between prasugrel- and 
      clopidogrel-treated patients. Overall, 17% of prasugrel-treated and 19% of 
      clopidogrel-treated patients received a PPI at hospital discharge. At 1 year, 
      patients discharged on a PPI versus no PPI had higher risks of MACE (adjusted 
      hazard ratio [HR] 1.38, 95% confidence interval [CI] 1.21-1.58) and GUSTO 
      moderate/severe bleeding (adjusted HR 1.55, 95% CI 1.15-2.09). Risk of MACE was 
      similar between prasugrel and clopidogrel regardless of PPI use (adjusted HR 
      0.88, 95% CI 0.62-1.26 with PPI, adjusted HR 1.07, 95% CI 0.90-1.28 without PPI, 
      interaction P=0.31). Comparative bleeding risk associated with prasugrel versus 
      clopidogrel use differed based on PPI use but did not reach statistical 
      significance (adjusted HR 0.73, 95% CI 0.36-1.48 with PPI, adjusted HR 1.34, 95% 
      CI 0.79-2.27 without PPI, interaction P=0.17). CONCLUSIONS: PPIs did not 
      significantly affect the MACE and bleeding risk associated with prasugrel use, 
      relative to clopidogrel. CLINICAL TRIAL REGISTRATION: URL: 
      https://www.clinicaltrials.gov. Unique identifier: NCT01088503.
CI  - (c) 2016 The Authors and Eli Lilly & Company. Published on behalf of the American 
      Heart Association, Inc., by Wiley Blackwell.
FAU - Jackson, Larry R 2nd
AU  - Jackson LR 2nd
AD  - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC 
      larry.jackson@dm.duke.edu.
FAU - Peterson, Eric D
AU  - Peterson ED
AD  - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
FAU - McCoy, Lisa A
AU  - McCoy LA
AD  - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
FAU - Ju, Christine
AU  - Ju C
AD  - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
FAU - Zettler, Marjorie
AU  - Zettler M
AD  - Eli Lilly & Company, Indianapolis, IN.
FAU - Baker, Brian A
AU  - Baker BA
AD  - Daiichi Sankyo, Inc, Parsippany, NJ.
FAU - Messenger, John C
AU  - Messenger JC
AD  - University of Colorado School of Medicine, Aurora, CO.
FAU - Faries, Douglas E
AU  - Faries DE
AD  - Eli Lilly & Company, Indianapolis, IN.
FAU - Effron, Mark B
AU  - Effron MB
AD  - Eli Lilly & Company, Indianapolis, IN.
FAU - Cohen, David J
AU  - Cohen DJ
AD  - Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City 
      School of Medicine, Kansas City, MO.
FAU - Wang, Tracy Y
AU  - Wang TY
AD  - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
LA  - eng
SI  - ClinicalTrials.gov/NCT01088503
PT  - Comparative Study
PT  - Journal Article
DEP - 20161021
PL  - England
TA  - J Am Heart Assoc
JT  - Journal of the American Heart Association
JID - 101580524
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Purinergic P2Y Receptor Antagonists)
RN  - A74586SNO7 (Clopidogrel)
RN  - G89JQ59I13 (Prasugrel Hydrochloride)
RN  - OM90ZUW7M1 (Ticlopidine)
SB  - IM
MH  - Acute Coronary Syndrome/*drug therapy/surgery
MH  - Aftercare
MH  - Aged
MH  - Cardiovascular Diseases/mortality
MH  - Clopidogrel
MH  - Comparative Effectiveness Research
MH  - Female
MH  - Gastrointestinal Hemorrhage/chemically induced/epidemiology
MH  - Hemorrhage/chemically induced/epidemiology
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*drug therapy/surgery
MH  - Myocardial Revascularization/statistics & numerical data
MH  - Percutaneous Coronary Intervention
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Prasugrel Hydrochloride/*therapeutic use
MH  - Proportional Hazards Models
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Purinergic P2Y Receptor Antagonists/*therapeutic use
MH  - Recurrence
MH  - Stroke/epidemiology
MH  - Ticlopidine/*analogs & derivatives/therapeutic use
MH  - Treatment Outcome
PMC - PMC5121485
OTO - NOTNLM
OT  - bleeding risk
OT  - clopidogrel
OT  - major adverse cardiovascular events
OT  - prasugrel
OT  - proton pump inhibitors
EDAT- 2016/10/30 06:00
MHDA- 2017/12/20 06:00
PMCR- 2016/10/01
CRDT- 2016/10/30 06:00
PHST- 2016/10/30 06:00 [pubmed]
PHST- 2017/12/20 06:00 [medline]
PHST- 2016/10/30 06:00 [entrez]
PHST- 2016/10/01 00:00 [pmc-release]
AID - JAHA.116.003824 [pii]
AID - JAH31753 [pii]
AID - 10.1161/JAHA.116.003824 [doi]
PST - epublish
SO  - J Am Heart Assoc. 2016 Oct 21;5(10):e003824. doi: 10.1161/JAHA.116.003824.