Drug Interaction Between Clopidogrel and Ranitidine or Omeprazole in Stable Coronary Artery Disease: A Double-Blind, Double Dummy, Randomized Study

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art_FURTADO_Drug_Interaction_Between_Clopidogrel_and_Ranitidine_or_Omeprazole_2016.PDF (768.08 KB)
Citações na Scopus
19
Tipo de produção
article
Data de publicação
2016
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
ADIS INT LTD
Autores
GIUGLIANO, Robert Patrick
Citação
AMERICAN JOURNAL OF CARDIOVASCULAR DRUGS, v.16, n.4, p.275-284, 2016
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background Proton-pump inhibitors (PPIs) are often prescribed to patients receiving dual antiplatelet therapy (DAPT). However, this class of medication, especially omeprazole, has been associated with a reduction in clopidogrel efficacy, leading many clinicians to substitute omeprazole with ranitidine. Objectives Our objective was to compare the antiplatelet effect of clopidogrel before and after the addition of omeprazole or ranitidine. Methods We measured platelet aggregability at baseline and after 1 week of clopidogrel 75 mg daily. Subjects were then randomized in a double-blinded, double-dummy fashion to omeprazole 20 mg twice daily (bid) or ranitidine 150 mg bid. We repeated aggregability tests after 1 additional week, using VerifyNow P2Y12 (TM) (Accumetrics; San Diego, CA, USA), depicting aggregability as percent inhibition of platelet aggregation (IPA). Results We enrolled 41 patients in the omeprazole group and 44 in the ranitidine group. IPA was significantly decreased after the addition of omeprazole to clopidogrel (from 26.3 +/- 32.9 to 17.4 +/- 33.1 %; p = 0.025), with no statistical significant changes observed in the ranitidine group (from 32.6 +/- 28.9 to 30.1 +/- 31.3 %; p = 0.310). The comparison of IPA in both groups at the end of the follow-up showed a trend toward significance (p = 0.07, 95 % confidence interval [CI] -1.19 to 26.59); after excluding homozygous patients for 2C19*2 genotype, the comparison of IPA between the groups reached statistical significance (32.7 +/- 30.8 vs. 17.7 +/- 33.4 %, respectively, for ranitidine and omeprazole groups; p = 0.04). Conclusions Unlike omeprazole, ranitidine did not influence platelet aggregability response to clopidogrel.
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URI
https://observatorio.fm.usp.br/handle/OPI/16148
Referências
  1. Abraham NS, 2010, J AM COLL CARDIOL, V56, P2051, DOI 10.1016/j.jacc.2010.09.010
  2. Amsterdam EA, 2014, J AM COLL CARDIOL, V64, pE139, DOI 10.1016/j.jacc.2014.09.017
  3. Angiolillo DJ, 2014, J AM COLL CARDIOL, V64, P1005, DOI 10.1016/j.jacc.2014.06.1170
  4. Aradi D, 2014, EUR HEART J, V35, P209, DOI 10.1093/eurheartj/eht375
  5. Aradi D, 2015, EUR HEART J, V36, P1762, DOI 10.1093/eurheartj/ehv104
  6. Bhatt DL, 2010, NEW ENGL J MED, V363, P1909, DOI 10.1056/NEJMoa1007964
  7. Bonaca MP, 2015, NEW ENGL J MED, V372, P1791, DOI 10.1056/NEJMoa1500857
  8. Breet NJ, 2010, JAMA-J AM MED ASSOC, V303, P754, DOI 10.1001/jama.2010.181
  9. Chen ZM, 2005, LANCET, V366, P1607
  10. Cuisset T, 2009, J AM COLL CARDIOL, V54, P1149, DOI 10.1016/j.jacc.2009.05.050
  11. Frelinger AL, 2012, J AM COLL CARDIOL, V59, P1304, DOI 10.1016/j.jacc.2011.12.024
  12. Geisleri T, 2008, EUR HEART J, V29, P1635, DOI 10.1093/eurheartj/ehn212
  13. Gilard M, 2008, J AM COLL CARDIOL, V51, P256, DOI 10.1016/j.jacc.2007.06.064
  14. Goodman SG, 2012, CIRCULATION, V125, P978, DOI 10.1161/CIRCULATIONAHA.111.032912
  15. Gurbel PA, 2003, CIRCULATION, V107, P2908, DOI 10.1161/01.CIR.0000072771.11429.83
  16. Ho PM, 2009, JAMA-J AM MED ASSOC, V301, P937, DOI 10.1001/jama.2009.261
  17. Hulot JS, 2010, J AM COLL CARDIOL, V56, P134, DOI 10.1016/j.jacc.2009.12.071
  18. Lazarus B, 2016, JAMA INTERN MED, V176, P238, DOI 10.1001/jamainternmed.2015.7193
  19. Levine GN, 2011, J AM COLL CARDIOL, V58, pE44, DOI 10.1016/j.jacc.2011.08.007
  20. Mauri L, 2014, NEW ENGL J MED, V371, P2155, DOI 10.1056/NEJMoa1409312
  21. Mega JL, 2009, NEW ENGL J MED, V360, P354, DOI 10.1056/NEJMoa0809171
  22. Nicolau J C, 2014, Arq Bras Cardiol, V102, P1
  23. Nicolau JC, 2015, AM HEART J, V170, P683, DOI 10.1016/j.ahj.2015.05.017
  24. O'Donoghue ML, 2009, LANCET, V374, P989, DOI 10.1016/S0140-6736(09)61525-7
  25. O'Gara PT, 2013, J AM COLL CARDIOL, V61, pE78, DOI 10.1016/j.jacc.2012.11.019
  26. Parri MS, 2013, INT J CARDIOL, V167, P2177, DOI 10.1016/j.ijcard.2012.05.080
  27. Pham JP, 2011, J AM COLL CARDIOL, V58, P1396, DOI 10.1016/j.jacc.2011.06.031
  28. Sabatine MS, 2005, NEW ENGL J MED, V352, P1179, DOI 10.1056/NEJMoa050522
  29. Schafer A, 2010, PHARMACOL RES, V62, P352, DOI 10.1016/j.phrs.2010.05.006
  30. Shah NH, 2015, PLOS ONE, V10, DOI 10.1371/journal.pone.0124653
  31. Shuldiner AR, 2009, JAMA-J AM MED ASSOC, V302, P849, DOI 10.1001/jama.2009.1232
  32. Sigterman KE, 2013, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD002095.pub5
  33. Siller-Matula JM, 2014, J THROMB HAEMOST, V12, P2, DOI 10.1111/jth.12445
  34. Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215
  35. Stone GW, 2013, LANCET, V382, P614, DOI 10.1016/S0140-6736(13)61170-8
  36. Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327
  37. Windecker S, 2014, EUR HEART J, V35, P2541, DOI 10.1093/eurheartj/ehu278
  38. Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482
  39. Yun KH, 2010, INT HEART J, V51, P13
  40. Yusuf S, 2001, NEW ENGL J MED, V345, P494

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Artigos e Materiais de Revistas Científicas - FM/MCP
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