title: Does Pantoprazole Affect the On-Treatment Platelet Reactivity in Patients With Acute STEMI Treated With ADP Receptor Blockers?-A Pilot Prospective Study.
abstract: BACKGROUND
  Proton pump inhibition (PPI) administrated together with adenosine diphosphate (ADP) receptor blockers (ADPRB) significantly reduces the risk of gastrointestinal bleeding. Nevertheless, there is a heated discussion about an interaction between PPI and ADPRB that leads to high on-treatment platelet reactivity (HTPR).
  
  
  OBJECTIVE
  Is there a relationship between pantoprazole PPI and HTPR on ADPRB therapy in patients with acute ST-elevation myocardial infarction (STEMI).
  
  
  METHODS
  Single center pilot study in patients with acute STEMI was performed. This study enrolled totally 87 patients (34 clopidogrel-treated and 53 new ADPRB-treated patients). Pantoprazole was administrated in 33 patients. HTPR was detected with ADP-induced light transmission aggregometry and vasodilator-stimulated phosphoprotein phosphorylation analysis. Samples were taken before coronary angiography (sample 1) and on the next day after the procedure (sample 2).
  
  
  RESULTS
  No significant differences were found in pantoprazole-treated patients and patients without PPI neither in sample 1 (59.2 ± 29.5% vs. 54.9 ± 22.7%, P = 0.49) nor in sample 2 (43.8 ± 27.2% vs. 37.0 ± 22.9%, P = 0.30). Similarly, there were no significant differences in the platelet reactivity index of vasodilator-stimulated phosphoprotein phosphorylation in both samples (sample 1: 53.3 ± 29.8% vs. 65.0 ± 20.5%, P = 0.11; sample 2: 30.8 ± 27.1% vs. 40.6 ± 27.5%, P = 0.19). A comparison of clopidogrel and new ADP receptor blockers in patients on pantoprazole PPI did not reveal significant differences in on-treatment platelet reactivity.
  
  
  CONCLUSIONS
  This study did not reveal interaction between pantoprazole and ADPRB in patients with acute STEMI.
authors.affiliation: 1Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic; and 2National Centre of Hemostasis and Thrombosis, Department of Hematology and Blood Transfusion, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Bolek
authors.forename: Matej
authors.initials: M
authors.lastname: Samoš
authors.forename: Radoslava
authors.initials: R
authors.lastname: Šimonová
authors.forename: František
authors.initials: F
authors.lastname: Kovář
authors.forename: Marián
authors.initials: M
authors.lastname: Fedor
authors.forename: Peter
authors.initials: P
authors.lastname: Galajda
authors.forename: Ján
authors.initials: J
authors.lastname: Staško
authors.forename: Peter
authors.initials: P
authors.lastname: Kubisz
authors.forename: Marián
authors.initials: M
authors.lastname: Mokáň
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000494:pharmacology*; D000241:Adenosine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets / Q000187:drug effects*; D015815:Cell Adhesion Molecules / Q000187:drug effects* / Q000378:metabolism; D000077144:Clopidogrel; D017023:Coronary Angiography; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008297:Male; D008840:Microfilament Proteins / Q000187:drug effects* / Q000378:metabolism; D008875:Middle Aged; D000077402:Pantoprazole; D062645:Percutaneous Coronary Intervention; D010750:Phosphoproteins / Q000187:drug effects* / Q000378:metabolism; D010766:Phosphorylation / Q000187:drug effects; D010865:Pilot Projects; D010974:Platelet Aggregation / Q000187:drug effects*; D000068799:Prasugrel Hydrochloride / Q000627:therapeutic use; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000494:pharmacology*; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use*; D000072657:ST Elevation Myocardial Infarction / Q000628:therapy*; D000077486:Ticagrelor; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000098662:Vasodilator-Stimulated Phosphoprotein
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D015815:Cell Adhesion Molecules; D008840:Microfilament Proteins; D010750:Phosphoproteins; D054328:Proton Pump Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D000098662:Vasodilator-Stimulated Phosphoprotein; D000077144:Clopidogrel; D000077402:Pantoprazole; D000068799:Prasugrel Hydrochloride; D000077486:Ticagrelor; D000241:Adenosine; D013988:Ticlopidine