Platelets Prohibition with Clopidogrel Alone versus with Proton-Pump Inhibitors

Background: Clopidogrel and proton-pump inhibitors (PPIs) are inert drugs that need cytochrome P450 enzymes to switch chemically to their active forms. The aim of this research is to evaluate the influences of three different types of PPIs on platelet restraining effect of clopidogrel. Methods: This study consecutively enlisted 100 patients (30 females and 70 males), ranging from 45 to 60 years with coronary artery disease from Ibn Al-Nafees Hospital. The patients randomly divided into four groups and each group consists of 25 patients. One of them treated with clopidogrel tablet (75 mg daily) alone. Others treated with clopidogrel (75 mg daily) and pantoprazole (20 mg daily), or esomeprazole (20 mg daily), or rabeprazole (20 mg daily) for a period of 10 days. Light transmission aggregometry instrument was used for the estimation of maximal platelet aggregation percent (MPA%). Results: The statistical outcomes after 10 days of treatments demonstrated that high inhibition of platelet aggregation was achieved in patients on clopidogrel alone 52.5% and low inhibition of platelet aggregation was confirmed in patients on clopidogrel and rabeprazole 43.3%. Conclusions: Even each drug of PPIs that used in this study changed the MPA% as compared to clopidogrel alone, but rabeprazole had an appreciable impact on MPA% and thereby on clinical adequacy of clopidogrel as platelets aggregation preventer drug.