title: Esomeprazole and rabeprazole did not reduce antiplatelet effects of aspirin/clopidogrel dual therapy in patients undergoing percutaneous coronary intervention: a prospective, randomized, case-control study.
abstract: OBJECTIVE
  Controversy has been prompted based on drug interaction between proton pump inhibitors (PPIs) and aspirin/clopidogrel leading to weakened effects. However, whether such interaction was drug-specific or class effect remains controversial. This study predicted the impact of esomeprazole and rabeprazole on efficacy of dual antiplatelet therapy (DAPT).
  
  
  METHODS
  This study, involving 150 patients, evaluated the efficacy of DAPT upon concomitant use of esomeprazole (40 mg/d) or rabeprazole (20 mg/d). Platelet reactivity was assessed by value of ADP-induced light transmittance aggregometry (LTA) and vasodilator-stimulated phosphoprotein phosphorylation-platelet reactivity index (VASP-PRI) at day 1, day 3 and day 30 end points after initiation of DAPT.
  
  
  RESULTS
  No significance were observed by post-hoc analysis of treatment-by-period interaction in LTA value and VASP-PRI value when compared with non-PPI users, which suggests no carryover effect in both PPIs over the 30-day treatment period. Moreover, no statistical differences was in LTA or VASP-PRI value in esomeprazole group while rabeprazole group showed decreased in antiplatelet function of DAPT at the day 3 and day 30 end points.
  
  
  CONCLUSIONS
  Although antiplatelet effect of DAPT were not affected upon concomitant use of both PPIs over the 30-day treatment period, esomeprazole exerts much more stable impact on antiplatelet effect than rabeprazole among respective end points.
authors.affiliation: a Department of Cardiovascular Medicine, Xijing Hospital , Fourth Military Medical University , Xi'an , China.
authors.forename: Li-Peng
authors.initials: LP
authors.lastname: Liu
authors.affiliation: a Department of Cardiovascular Medicine, Xijing Hospital , Fourth Military Medical University , Xi'an , China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: a Department of Cardiovascular Medicine, Xijing Hospital , Fourth Military Medical University , Xi'an , China.
authors.forename: Rui
authors.initials: R
authors.lastname: Si
authors.affiliation: a Department of Cardiovascular Medicine, Xijing Hospital , Fourth Military Medical University , Xi'an , China.
authors.forename: Ming
authors.initials: M
authors.lastname: Yuan
authors.affiliation: a Department of Cardiovascular Medicine, Xijing Hospital , Fourth Military Medical University , Xi'an , China.
authors.forename: Kang
authors.initials: K
authors.lastname: Cheng
authors.affiliation: a Department of Cardiovascular Medicine, Xijing Hospital , Fourth Military Medical University , Xi'an , China.
authors.forename: Wen-Yi
authors.initials: WY
authors.lastname: Guo
mesh_terms: D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D016022:Case-Control Studies; D015815:Cell Adhesion Molecules / Q000378:metabolism; D000077144:Clopidogrel; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D064098:Esomeprazole / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008840:Microfilament Proteins / Q000378:metabolism; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D010750:Phosphoproteins / Q000378:metabolism; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D064750:Rabeprazole / Q000627:therapeutic use*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000098662:Vasodilator-Stimulated Phosphoprotein
chemical_list: D015815:Cell Adhesion Molecules; D008840:Microfilament Proteins; D010750:Phosphoproteins; D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors; D000098662:Vasodilator-Stimulated Phosphoprotein; D064750:Rabeprazole; D000077144:Clopidogrel; D064098:Esomeprazole; D013988:Ticlopidine; D001241:Aspirin
keywords: drug interaction; dual antiplatelet therapy; esomeprazole; platelet reactivity; rabeprazole