PulseExploreJournal ClubResearchersJournals
Instagram
HomeJournal ClubExplore
Synapse
⌘+K
Synapse
January 27, 2016Journal of Breath ResearchOpen Access

Changes in CYP2C19 enzyme activity evaluated by the 13 C-pantoprazole breath test after co-administration of clopidogrel and proton pump inhibitors following percutaneous coronary intervention and correlation to platelet reactivity

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Does co-administration of omeprazole or esomeprazole compared to pantoprazole or ranitidine alter CYP2C19 enzyme activity and platelet reactivity in CAD patients on clopidogrel after PCI?

Population

59 patients with coronary artery disease treated with dual antiplatelet therapy 30 days after successful PCI…

Comparison

Omeprazole or esomeprazole vs Pantoprazole or ranitidine

Design

RCT, randomized to one of 4 antacid therapies

Follow-up

30 days

Authors

AHAdrien HarveyAMAnil ModakUDUgo Déry

Discussion

Loading...

Member takes

Overview

Avoid omeprazole or esomeprazole with clopidogrel post-PCI; confirms differential CYP2C19 inhibition versus pantoprazole or ranitidine in RCT.

Structured PICO

Does co-administration of omeprazole or esomeprazole compared to pantoprazole or ranitidine alter CYP2C19 enzyme activity and platelet reactivity in CAD patients on clopidogrel after PCI?

P
Population
59 patients with coronary artery disease (CAD) treated with dual antiplatelet therapy (clopidogrel and aspirin) 30 days after successful PCI with stent placement
I
Intervention
Omeprazole or esomeprazole
C
Comparator
Pantoprazole or ranitidine
O
Outcome
Changes in CYP2C19 enzyme activity evaluated by the [13C]-pantoprazole breath test and platelet reactivity (VASP phosphorylation and light transmittance aggregometry) before and 30 days after treatmentsurrogate

Omeprazole and esomeprazole, but not pantoprazole or ranitidine, attenuate the antiplatelet effect of clopidogrel by inhibiting CYP2C19 enzyme activity.

Cite This Study

Harvey et al. (2016) studied this question.

synapsesocial.com/papers/6a880198ce59b4d55bcf03c1https://doi.org/10.1088/1752-7155/10/1/017104
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1High on-treatment platelet reactivity by more than one agonist predicts 12-month follow-up cardiovascular death and non-fatal myocardial infarction in acute coronary syndrome patients receiving coronary stenting2010 · 46 citations
  2. 2Flow Cytometry Analysis of Intracellular VASP Phosphorylation for the Assessment of Activating and Inhibitory Signal Transduction Pathways in Human Platelets1999 · 299 citations
  3. 3Differential Effects of Omeprazole and Pantoprazole on the Pharmacodynamics and Pharmacokinetics of Clopidogrel in Healthy Subjects: Randomized, Placebo-Controlled, Crossover Comparison Studies2010 · 284 citations
  4. 4Influence of Omeprazole on the Antiplatelet Action of Clopidogrel Associated With Aspirin2008 · 1,017 citations
  5. 5Genetic determinants of on-clopidogrel high platelet reactivity2011 · 50 citations