Pantoprazole did not significantly increase the rate of clopidogrel low-response compared to ranitidine (11.1% vs 10.5%, p=0.954) in patients receiving dual antiplatelet therapy.
RCT (n=40)
Single-blind
Computer-generated randomized table
No
Does pantoprazole reduce the antiplatelet effect of clopidogrel in patients on dual antiplatelet therapy after PCI?
Absolute Event Rate: 11.1% vs 10.5%
p-value: p=0.954
BACKGROUND/AIMS: Concerns that proton pump inhibitors (PPIs) diminish the efficacy of clopidogrel could hamper the appropriate prescription of PPIs. We evaluated the influence of pantoprazole on the antiplatelet effect of clopidogrel compared with ranitidine, which is regarded as safe, after stratification of the population according to the presence of a cytochrome (CYP) 2C19 polymorphism in Korea. METHODS: Forty patients who underwent dual antiplatelet therapy were randomized to receive pantoprazole (n=20) or ranitidine (n=20). Platelet aggregation was evaluated by impedance aggregometry at baseline (D0) and 8 days after acid-lowering treatments (D9). CYP2C19 was genotyped by polymerase chain reaction-restriction fragment length polymorphism. RESULTS: polymorphism. CONCLUSIONS: This study showed that pantoprazole does not increase platelet aggregation in patients receiving dual antiplatelet therapy (ClinicalTrials.gov number: NCT02733640).
Choi et al. (Tue,) conducted a rct in Acute coronary syndromes post-percutaneous coronary intervention (n=40). Pantoprazole vs. Ranitidine 150 mg twice-daily was evaluated on Clopidogrel low-response (CLR) (p=0.954). Pantoprazole did not significantly increase the rate of clopidogrel low-response compared to ranitidine (11.1% vs 10.5%, p=0.954) in patients receiving dual antiplatelet therapy.