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March 25, 2025The Korean Journal of Internal MedicineOpen Access

Tegoprazan shows similar platelet reactivity to PPIs in patients on clopidogrel post-PCI.

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Why the study?

Data on the interactions between clopidogrel and tegoprazan are limited.

Does tegoprazan compared to PPIs affect platelet reactivity in patients treated with clopidogrel after coronary stenting?

Population

262 patients taking aspirin and clopidogrel DAPT after PCI

Comparison

Tegoprazan vs proton-pump inhibitors

Design

Retrospective database study

Follow-up

12 months

Key result

Tegoprazan resulted in similar platelet reactivity compared to proton-pump inhibitors at 3, 6, and 12 months in patients receiving clopidogrel after percutaneous coronary intervention.

Authors

OLOh‐Hyun LeeJRJi Woong RohYKYongcheol Kim

Discussion

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Member takes

Overview

May support tegoprazan as PPI alternative post-PCI; hypothesis-generating and should not yet change practice.

Study Design

Type

Cohort (n=262)

Multicenter

No

Structured PICO

Does tegoprazan compared to PPIs affect platelet reactivity in patients treated with clopidogrel after coronary stenting?

P
Population
262 patients who underwent percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation and received dual antiplatelet therapy (aspirin and clopidogrel), mean age 65.4, 73.7% male, single-center in Korea.
I
Intervention
Tegoprazan combined with dual antiplatelet therapy (aspirin and clopidogrel) after PCI.
C
Comparator
Proton-pump inhibitors (PPIs) combined with dual antiplatelet therapy (aspirin and clopidogrel) after PCI.
O
Outcome
Platelet reaction unit (PRU) values at 3, 6, and 12 months after PCI measured using VerifyNow P2Y12 assays.surrogate

Main Result

Effect estimate: Mean difference -4 (95% CI -23 to 15)

Absolute Event Rate: 157% vs 162%

p-value: p=0.659

Tegoprazan does not significantly affect clopidogrel-induced platelet reactivity compared to traditional PPIs, suggesting it is a safe gastroprotective alternative for patients on DAPT after PCI.

Limitations

  • Retrospective analysis with a relatively small study population derived from a single center
  • Medication adherence and tolerability were not evaluated
  • Potential interactions with food or other medications were not considered
  • Baseline PRU data were available for only a subset of the study population
  • Small sample sizes within each PPI subgroup precluded detailed analysis
  • Genetic polymorphisms influencing antiplatelet function were not investigated
  • Retrospective analysis
  • Relatively small study population from a single center
  • Medication adherence and tolerability not evaluated
  • Potential interactions with food or other medications not considered
  • Baseline PRU data available for only a subset
  • Small sample sizes within each PPI subgroup
  • Genetic polymorphisms not investigated

Cite This Study

Lee et al. (2025) conducted a cohort in Coronary artery disease requiring percutaneous coronary intervention and dual antiplatelet therapy (n=262). Tegoprazan vs. Proton-pump inhibitors (PPIs) was evaluated on Platelet reaction unit (PRU) value at 3 months (Mean difference -4, 95% CI -23 to 15, p=0.659). Tegoprazan resulted in similar platelet reactivity compared to proton-pump inhibitors at 3, 6, and 12 months in patients receiving clopidogrel after percutaneous coronary intervention.

synapsesocial.com/papers/6a1571a8cb801b7f954e84fchttps://doi.org/10.3904/kjim.2024.399
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