title: Do proton pump inhibitors attenuate the effect of aspirin on platelet aggregation? A randomized crossover study.
abstract: It is common practice to coadminister proton pump inhibitors with aspirin to diminish the risk of upper gastrointestinal bleeding. This is the first study that investigated the potential impact of a proton pump inhibitor on aspirin effects on platelet aggregation. Twenty-four hypertensive subjects eligible for treatment with low-dose enteric-coated aspirin (LDECA) for primary prevention of cardiovascular disease were randomized to receive 100 mg LDECA or 100 mg LDECA plus 30 mg lansoprazole for 4 weeks. Then, participants were crossed over to the alternative regimen for another 4 weeks. Salicylic, gastrin, and pepsinogen I blood level counting were used to ensure adherence to treatment. Platelet aggregation was evaluated by light transmittance aggregometry and PFA100. The LDECA administration reduced arachidonic acid (P < 0.001), collagen (P < 0.01), and epinephrine (P < 0.001) tests. These changes paralleled an increase in collagen/epinephrine duration (P < 0.001) but not in collagen/adenosine diphosphate duration and platelet count. No significant difference was found in any of these platelets' function tests with LDECA alone versus LDECA plus lansoprazole. A significant increase in salicylic levels was observed in patients on LDECA as well as in those on LDECA plus lansoprazole, whereas gastrin and pepsinogen I levels were increased only when lansoprazole was added. These data suggest that the concomitant use of the lansoprazole at 30-mg daily does not influence the long-term effect of LDECA on platelet aggregation. Furthermore, they might imply that an interaction of LDECA with other proton pump inhibitors on platelet aggregation is unlikely.
authors: 3rd Department of Medicine, University of Athens, Sotiria Hospital, Athens 11527, Greece.
authors: Adam B
authors: AB
authors: Adamopoulos
authors: George N
authors: GN
authors: Sakizlis
authors: Efthimia G
authors: EG
authors: Nasothimiou
authors: Ioanna
authors: I
authors: Anastasopoulou
authors: Eugenia
authors: E
authors: Anastasakou
authors: Paraskevi
authors: P
authors: Kotsi
authors: Anastasia
authors: A
authors: Karafoulidou
authors: George S
authors: GS
authors: Stergiou
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000494:pharmacology; D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000494:pharmacology; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D018592:Cross-Over Studies; D004347:Drug Interactions; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D010979:Platelet Function Tests; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000494:pharmacology*
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D001241:Aspirin