Literature DB >> 20151060

The impact of treatment with omeprazole on the effectiveness of clopidogrel drug therapy during the first year after successful coronary stenting.

Michael N Zairis1, George Z Tsiaousis, Nikolaos G Patsourakos, Anastassios Theodossis Georgilas, Constantinos F Kontos, Evdokia N Adamopoulou, Konstantinos Vogiatzidis, Spyros K Argyrakis, Constantine N Fakiolas, Stefanos G Foussas.   

Abstract

BACKGROUND: Because clopidogrel is converted to its active metabolite by P450 isoenzymes, which are also involved in the metabolism of omeprazole, there is concern regarding whether the action of clopidogrel would be reduced in patients also taking omeprazole.
OBJECTIVE: To evaluate the impact of omeprazole administration on the effectiveness of clopidogrel drug therapy during the first year following successful coronary stenting (CS).
METHODS: A total of 588 consecutive patients who underwent successful CS for stable or unstable coronary artery disease were studied. Patients were classified into those who were treated (group A, n=340) or not treated (group B, n=248) with omeprazole for seven or more consecutive days during the entire observation period. The composite of cardiac death or rehospitalization for nonfatal myocardial infarction during the first year was the prespecified primary study end point.
RESULTS: Baseline characteristics, and dual clopidogrel and acetylsalicylic acid drug therapy were well balanced between the study groups. By one year, the primary end point was reached by 58 (9.9%) patients, including 20 (3.4%) who died due to cardiac reasons and 38 (6.5%) who were rehospitalized because of a nonfatal myocardial infarction. Patients in groups A and B, respectively, were at similar risk of the primary composite end point (10% versus 9.7%, hazard ratio 1.1 [95% CI 0.6 to 1.8]; P=0.89).
CONCLUSIONS: According to the results of the present study, treatment with omeprazole had no impact on the clinical efficacy of clopidogrel drug therapy during the first year after successful CS.

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Year:  2010        PMID: 20151060      PMCID: PMC2851393          DOI: 10.1016/s0828-282x(10)70008-8

Source DB:  PubMed          Journal:  Can J Cardiol        ISSN: 0828-282X            Impact factor:   5.223


  19 in total

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2.  Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes.

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Review 3.  Drug insight: Clopidogrel nonresponsiveness.

Authors:  Paul A Gurbel; Udaya S Tantry
Journal:  Nat Clin Pract Cardiovasc Med       Date:  2006-07

4.  Cytochrome P450 2C19 loss-of-function polymorphism is a major determinant of clopidogrel responsiveness in healthy subjects.

Authors:  Jean-Sébastien Hulot; Alessandra Bura; Eric Villard; Michel Azizi; Véronique Remones; Catherine Goyenvalle; Martine Aiach; Philippe Lechat; Pascale Gaussem
Journal:  Blood       Date:  2006-06-13       Impact factor: 22.113

5.  Variable extent of clopidogrel responsiveness in patients after coronary stenting.

Authors:  Ralf Grossmann; Olga Sokolova; Axel Schnurr; Andreas Bonz; Christian Porsche; Achim Obergfell; Björn Lengenfelder; Ulrich Walter; Martin Eigenthaler
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6.  Aspirin and clopidogrel drug response in patients undergoing percutaneous coronary intervention: the role of dual drug resistance.

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7.  A population-based study of the drug interaction between proton pump inhibitors and clopidogrel.

Authors:  David N Juurlink; Tara Gomes; Dennis T Ko; Paul E Szmitko; Peter C Austin; Jack V Tu; David A Henry; Alex Kopp; Muhammad M Mamdani
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8.  Atorvastatin reduces the ability of clopidogrel to inhibit platelet aggregation: a new drug-drug interaction.

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9.  Cytochrome P450 3A inhibition by ketoconazole affects prasugrel and clopidogrel pharmacokinetics and pharmacodynamics differently.

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10.  The antiaggregating activity of clopidogrel is due to a metabolic activation by the hepatic cytochrome P450-1A.

Authors:  P Savi; J Combalbert; C Gaich; M C Rouchon; J P Maffrand; Y Berger; J M Herbert
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  15 in total

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Review 2.  Conflicting results between randomized trials and observational studies on the impact of proton pump inhibitors on cardiovascular events when coadministered with dual antiplatelet therapy: systematic review.

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3.  What you need to know when you prescribe a proton pump inhibitor.

Authors:  A Norman; C J Hawkey
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Review 4.  Clopidogrel and proton pump inhibitors--where do we stand in 2012?

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Journal:  World J Gastroenterol       Date:  2012-05-14       Impact factor: 5.742

5.  Are There Different Evidence Thresholds for Genomic Versus Clinical Precision Medicine? A Value of Information-Based Framework Applied to Antiplatelet Drug Therapy.

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Review 6.  Drug-drug interaction profiles of proton pump inhibitors.

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Journal:  Clin Pharmacokinet       Date:  2010-08       Impact factor: 6.447

7.  Impact of proton pump inhibitors on efficacy of clopidogrel: Review of evidence.

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8.  Clopidogrel and proton pump inhibitor (PPI) interaction: separate intake and a non-omeprazole PPI the solution?

Authors:  S Kenngott; R Olze; M Kollmer; H Bottheim; A Laner; E Holinski-Feder; M Gross
Journal:  Eur J Med Res       Date:  2010-05-18       Impact factor: 2.175

9.  Clopidogrel and interaction with proton pump inhibitors: comparison between cohort and within person study designs.

Authors:  Ian J Douglas; Stephen J W Evans; Aroon D Hingorani; Anthony M Grosso; Adam Timmis; Harry Hemingway; Liam Smeeth
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Review 10.  Clopidogrel-Proton Pump Inhibitor Drug-Drug Interaction and Risk of Adverse Clinical Outcomes Among PCI-Treated ACS Patients: A Meta-analysis.

Authors:  Michael A Serbin; Gregory F Guzauskas; David L Veenstra
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