Key result
Omeprazole therapy resulted in significantly more high on-treatment platelet reactivity than famotidine or pantoprazole (48% vs 33% and 31% at >208 PRUs, P=0.04).
Why the study?
Does omeprazole increase high on-treatment platelet reactivity compared to famotidine or pantoprazole in patients treated with aspirin and clopidogrel?
Population
Patients treated with aspirin and clopidogrel for at least 1 month
Comparison
Omeprazole 20 mg twice daily for 1 month vs Famotidine 40 mg twice daily and pantoprazole 20…
Design
RCT, Randomized crossover design
Follow-up
3 consecutive 1-month treatment periods
Authors
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Clinicians should prefer famotidine or pantoprazole over omeprazole for gastroprotection during DAPT; confirms differential PPI effects on clopidogrel response.
RCT
Randomized
Does omeprazole increase high on-treatment platelet reactivity compared to famotidine or pantoprazole in patients treated with aspirin and clopidogrel?
p-value: p=0.04
In patients on aspirin and clopidogrel, omeprazole therapy is associated with significantly higher rates of high on-treatment platelet reactivity compared to famotidine or pantoprazole.
Arbel et al. (2013) conducted an RCT in Patients treated with aspirin and clopidogrel. Omeprazole vs. Famotidine 40 mg twice daily and pantoprazole 20 mg twice daily was evaluated on High on-treatment platelet reactivity (HPR) defined by >208 PRUs (p=0.04). Omeprazole therapy resulted in significantly more high on-treatment platelet reactivity than famotidine or pantoprazole (48% vs 33% and 31% at >208 PRUs, P=0.04).
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