Effects of omeprazole or pantoprazole on platelet function in non-ST-segment elevation acute coronary syndrome patients receiving clopidogrel  

作　　者：Ruo-Xi Gu Xiao-Zeng Wang Jing Li Jie Deng Xing-Xing Li Jiao Wang 

机构地区：[1]Department of Cardiology,General Hospital of Shenyang Military Region

出　　处：《Military Medical Research》2017年第2期70-79,共10页军事医学研究（英文版）

基　　金：supported by National Key Technology R&D Program in the "Twelfth Five-Year" Plan of China(2011BAI11B07)

摘　　要：Background: This study evaluated the effect of omeprazole or pantoprazole on platelet reactivity in non-STsegment elevation acute coronary syndrome(NSTE-ACS) patients receiving clopidogrel.Methods: Consecutive patients with NSTE-ACS(n =620) from general hospital of Shenyang Military Command were randomized to the omeprazole or pantoprazole(20mg/d) group(1:1), and received routine dual antiplatelet treatment. Patients' reversion rate of adenosine diphosphate-induced platelet aggregation(ADP-PA) was assessed at baseline, 12 to 24 h after administration of medication, and after 72 h of percutaneous coronary intervention(PCI). The primary endpoint of the study was platelet reactivity assessed with ADP-PA at 30 days after PCI. Adverse events(AEs) were recorded for 30-day and 180-day follow-up periods.Results: There were no significant differences between both the groups in platelet response to clopidogrel at 12–24h after drug administration(54.09%±18.90% vs. 51.62%±19.85%, P=0.12), 72 h after PCI(52.15%±19.45% vs. 49.66%±20.05%, P=0.18), and 30 days after PCI(50.44%±14.54% vs. 48.52%±15.08%, P=0.17). The rate of AEs did not differ significantly between groups during the 30-day(15.2% vs. 14.8%, P=0.91) and 180-day(16.5% vs. 14.5%, P=0.50) follow-up periods after PCI.Conclusion: The addition of omeprazole or pantoprazole to clopidogrel did not restrict the effect of platelet aggregation by reducing the conversion of clopidogrel. Compared with clopidogrel alone, pantoprazole-clopidogrel and omeprazoleclopidogrel combinations did not increase the incidence of adverse clinical events during 30-day and 180-day follow-up periods after PCI.Background： This study evaluated the effect of omeprazole or pantoprazole on platelet reactivity in non-STsegment elevation acute coronary syndrome（NSTE-ACS） patients receiving clopidogrel.Methods： Consecutive patients with NSTE-ACS（n =620） from general hospital of Shenyang Military Command were randomized to the omeprazole or pantoprazole（20mg/d） group（1：1）, and received routine dual antiplatelet treatment. Patients＇ reversion rate of adenosine diphosphate-induced platelet aggregation（ADP-PA） was assessed at baseline, 12 to 24 h after administration of medication, and after 72 h of percutaneous coronary intervention（PCI）. The primary endpoint of the study was platelet reactivity assessed with ADP-PA at 30 days after PCI. Adverse events（AEs） were recorded for 30-day and 180-day follow-up periods.Results： There were no significant differences between both the groups in platelet response to clopidogrel at 12–24h after drug administration（54.09%±18.90% vs. 51.62%±19.85%, P=0.12）, 72 h after PCI（52.15%±19.45% vs. 49.66%±20.05%, P=0.18）, and 30 days after PCI（50.44%±14.54% vs. 48.52%±15.08%, P=0.17）. The rate of AEs did not differ significantly between groups during the 30-day（15.2% vs. 14.8%, P=0.91） and 180-day（16.5% vs. 14.5%, P=0.50） follow-up periods after PCI.Conclusion： The addition of omeprazole or pantoprazole to clopidogrel did not restrict the effect of platelet aggregation by reducing the conversion of clopidogrel. Compared with clopidogrel alone, pantoprazole-clopidogrel and omeprazoleclopidogrel combinations did not increase the incidence of adverse clinical events during 30-day and 180-day follow-up periods after PCI.

关 键 词：OMEPRAZOLE PANTOPRAZOLE CLOPIDOGREL Platelet response Non-ST-segment elevation acute coronary syndrome 

分 类 号：R541.4[医药卫生—心血管疾病]