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Friday, April 30, 2010

More Evidence that PPIs Blunt Antiplatelet Activity

Posted by Prahallad Panda on 7:28 PM Comments

myocardial infarction - Myokardinfarkt - schemeImage via Wikipedia
This link is all about the warning of FDA in concomitant use of some proton pump inhibitors (PPI) with clopidogrel; a blood thinning agent usually prescribed after stent placements and other cases of coronary artery disease treatment. It has been seen by the researchers that pantaprazole a PPI prescribed to reduce adverse effect of aspirin, which is also co-prescribed along with clopidogrel may interfere with the action of clopidogrel, adversely affecting the task of blood thinning.
The risk of rehospitalization for myocardial infarction (MI) almost doubled in patients treated with both a proton pump inhibitor (PPI) and clopidogrel (Plavix) after acute MI or coronary stent deployment, data from a retrospective cohort study showed.
PPIs are frequently used to reduce the risk of gastrointestinal bleeding in patients treated with clopidogrel. However, a growing volume of evidence has suggested that PPIs might reduce clopidogrel's efficacy, the authors wrote.
In one recent study, patients treated with omeprazole (Prilosec) in addition to aspirin and clopidogrel had a significantly higher platelet reactivity index score after seven days of treatment than patients who didn't get the PPI (J Am Coll Cardiol 2008; 51: 256-60).
However, a subgroup analysis of a large clinical trial showed no increased risk of adverse events in patients who received clopidogrel with or without a PPI (Circulation 2008; 118(suppl 2): Abstract 3999).
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