Startseite Antiaggregation effect of clopidogrel in coronary heart disease patients using omeprazole
Artikel
Lizenziert
Nicht lizenziert Erfordert eine Authentifizierung

Antiaggregation effect of clopidogrel in coronary heart disease patients using omeprazole

  • Dian Hasiannami Boru Munthe , Siti Sjamsiah Sargo EMAIL logo und Mohammad Yogiarto EMAIL logo
Veröffentlicht/Copyright: 25. Januar 2020
Journal of Basic and Clinical Physiology and Pharmacology
Aus der Zeitschrift Journal of Basic and Clinical Physiology and Pharmacology Band 30 Heft 6

Abstract

Background

Antiplatelet agents used in coronary heart disease (CHD) cause gastrointestinal side effects. Omeprazole can prevent and cure these antiplatelet side effects. Clopidogrel combined with aspirin increases the risk of gastrointestinal tract ulcers and bleeding. This research studied the effect of omeprazole on the antiplatelet effect of clopidogrel.

Methods

CHD patients using clopidogrel and aspirin receive omeprazole 20 mg in a single dose for 10 days. Platelet antiaggregation point for clopidogrel was measured using VerifyNow P2Y12. The cutoff points used were: low on treatment platelet reactivity (LPR) <85 P2Y12 reaction unit (PRU), normal on treatment platelet reactivity (NPR) 85–208 PRU, and high on treatment platelet reactivity (HPR) >208 PRU.

Results

Using the paired t-test PRU points pre- and post-omeprazole were 154 ± 85.89 PRU and 169.4 ± 56.15 PRU, respectively. The PRU points were consistent or decreased from the previous PRU points below the HPR cutoff (p: 0.215; >0.05). Before omeprazole use, five patients were categorized as NPR, two patients as LPR, and three patients as HPR. After omeprazole use, two patients, each from HPR and NPR category had a PRU point >208; the rest showed results below the HPR point.

Conclusions

In this study the PRU points of clopidogrel after omeprazole use showed a PRU <208. The hypothesis that omeprazole may reduce the antiaggregation effect of clopidogrel as shown by the increase in PRU above the cutoff points >208 PRU (HPR) was not proven.

Keywords: clopidogrel; coronary heart disease (CHD); omeprazole; P2Y12 reaction unit (PRU)

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: This research involves human subjects complied with all relevant national regulations, institutional policies, and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors’ institutional review board (2015), or equivalent committee. (614/Panke.KKE/XII/2015).

References

[1] Abraham NS, Hlatky MA, Antman EM, Bhatt DL, Bjorkman DJ, Clark CB, et al. ACCF/ACG/AHA 2010 expert consensus document on the concomitant use of proton pump inhibitors and thienopyridines: a focused update of the ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use. A report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. J Am Coll Cardiol 2010;56;2619–33.10.1161/CIR.0b013e318202f701Suche in Google Scholar PubMed

[2] Schmidt M, Johansen M, Maeng M, Kaltoft A, Jensen LO, Tilsted H, et al. Concomitant use of clopidogrel and statins and risk of major adverse cardiovascular events following coronary stent implantation. Br J Clin Pharmacol 2012;74:161–70.10.1111/j.1365-2125.2012.04169.xSuche in Google Scholar PubMed PubMed Central

[3] Scott S, Sangkuhl K, Stein C, Hulot J-S, Mega J, Roden D, et al. Clinical pharmacogenetics implementation consortium guidelines for CYP2C19 genotype and clopidogrel therapy: 2013 update. Clin Pharmacol Therapeut 2013;94:317–23.10.1038/clpt.2013.105Suche in Google Scholar PubMed PubMed Central

[4] Laine L, Hennekens C. Proton pump inhibitor and clopidogrel interaction: fact or fiction. Clin Rev Am J Gastroenterol 2010;105:34–41.10.1038/ajg.2009.638Suche in Google Scholar PubMed

[5] Ogu C, Maxa J. Drug interactions due to cytochrome P450. Pharmacol Notes BUMC Proc 2000;13:421–3.10.1080/08998280.2000.11927719Suche in Google Scholar PubMed PubMed Central

[6] Holmes D, Dehmer G, Kaul S, Leifer D, O’Gara P, Stein M. ACCF/AHA clopidogrel clinical alert: approaches to the FDA “Box Waning”. A report of The American College of Cardiology Foundation Task Force on clinical expert consensus documents and The American Heart Association. Circulation 2010;122:537–57.10.1161/CIR.0b013e3181ee08edSuche in Google Scholar PubMed

[7] Brar S, Berg J, Marcucci R, Price M, Valgimigli M, Kim S, et al. Impact of platelet reactivity on clinical outcomes after percutaneous coronary intervention: a collaborative meta-analysis of individual participant data. J Am Coll Cardiol 2011;58:1945–54.10.1016/j.jacc.2011.06.059Suche in Google Scholar PubMed

[8] Yamane K, Kato Y, Tazaki J, Tomohisa M, Takeru I, Masao J, et al. Effects of PPI and an H2 blocker on the antiplatelet function of clopidogrel in Japanese patients under dual antiplatelet therapy. J Atheroscler Thromb 2012;19:559–69.10.5551/jat.11601Suche in Google Scholar PubMed

[9] Kwan J, Htun W, Huang Y, Ko W, Kwan T. Effect of proton pump inhibitors on platelet inhibition activity of clopidogrel in Chinese patients with percutaneous coronary intervention. Vasc Health Risk Manag 2011;7:399–404.10.2147/VHRM.S22273Suche in Google Scholar PubMed PubMed Central

[10] Patrono C, Baigent C, Hirsh J, Roth G. Antiplatelet drug, American College Of Chest Physicians evidence-based clinical practice guidelines 8th edition, ACCP Guidelines. Chest 2008;133:199S–233S.10.1378/chest.08-0672Suche in Google Scholar PubMed

[11] Chan M. Clopidogrel pharmacogenetics of east, south, and other Asian populations. Eur Heart J Suppl 2012;14:A41–2.10.1093/eurheartj/sur035Suche in Google Scholar

Received: 2019-09-13
Accepted: 2019-11-20
Published Online: 2020-01-25

© 2019 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Reviews
  2. Pharmacist contributions in the treatment of diabetes mellitus in Southeast Asia: a narrative review
  3. The implementation of a chronic disease management program (Prolanis) in Indonesia: a literature review
  4. Original Articles
  5. Quercetin attenuates acute predator stress exposure-evoked innate fear and behavioral perturbation
  6. Evaluating current practices and policies in the use of injectable medicines for treating myalgia in a primary care center in Pamekasan, Indonesia
  7. The contemporary role and potential of pharmacist contribution for community health using social media
  8. Evaluation of rational drug use based on World Health Organization prescribing indicators in a primary care center in Pamekasan East Java, Indonesia
  9. The prescription patterns of second-generation antipsychotics in schizophrenia outpatient setting
  10. Factors affecting community pharmacist’s service for women with chronic diseases during pregnancy and breastfeeding: application of the Health Belief Model
  11. Overview of therapeutic changes in antiepileptic drugs in adult patients
  12. Exploration of barriers affecting job satisfaction among community pharmacists
  13. Patients’ characteristics and their adherence to insulin therapy
  14. Correlation of chemotherapy costs with quality of life in nasopharyngeal cancer patients
  15. Impact of educational preeclampsia prevention booklet on knowledge and adherence to low dose aspirin among pregnant women with high risk for preeclampsia
  16. Translation, cultural adaptation, and validation of the quality of well being self-administered questionnaire in general population in Indonesia
  17. Knowledge, attitude, and practice of pharmacists towards management of hypertension in primary care centers
  18. Medication adherence in diabetes mellitus patients at Tanjung Karang Primary Health Care Center, Mataram
  19. Decreasing angiogenesis vasa vasorum through Lp-PLA2 and H2O2 inhibition by PSP from Ganoderma lucidum in atherosclerosis: in vivo diabetes mellitus type 2
  20. Antiaggregation effect of clopidogrel in coronary heart disease patients using omeprazole
  21. The effect of curcuma (Curcuma xanthorrizha roxb.) extract as an adjuvant of captopril therapy on cardiac histopathology of male mice (Mus musculus) with hypertension
  22. Coenzyme Q10 nanostructured lipid carriers as an inducer of the skin fibroblast cell and its irritability test in a mice model
  23. Medical problems in patients with chronic kidney disease undergoing hemodialysis and their therapy
  24. ADMET properties of novel 5-O-benzoylpinostrobin derivatives
  25. Development of nonalcoholic fatty liver disease model by high-fat diet in rats
  26. Molecular docking of novel 5-O-benzoylpinostrobin derivatives as wild type and L858R/T790M/V948R mutant EGFR inhibitor
  27. The relationship between the level of education and accuracy of insulin injection techniques in DM patients with measurement of HbA1c values
  28. The effect of premixed insulin to blood glucose concentration in patients with type 2 diabetes mellitus
  29. Intravenous insulin therapy in diabetes mellitus with hyperglycemic crisis and intercurrent illness
  30. Adherence behavior assessment of oral antidiabetic medication use: a study of patient decisions in long-term disease management in primary health care centers in Surabaya
  31. Evaluation to the chemotherapy use in patients with diffuse large B-cell lymphoma
  32. Analysis of the use and cost of stress ulcer prophylaxis for surgical inpatients
  33. Antineuroinflammation activity of n-butanol fraction of Marsilea crenata Presl. in microglia HMC3 cell line
  34. The enhancement of Arg1 and activated ERβ expression in microglia HMC3 by induction of 96% ethanol extract of Marsilea crenata Presl. leaves
  35. Ternary solid dispersion to improve solubility and dissolution of meloxicam
  36. Improving solubility and dissolution of meloxicam by solid dispersion using hydroxypropyl methylcellulose 2910 3 cps and nicotinamide
  37. o-Hydroxycinnamic derivatives as prospective anti-platelet candidates: in silico pharmacokinetic screening and evaluation of their binding sites on COX-1 and P2Y12 receptors
  38. The change of proinflammatory cytokine tumor necrosis factor α level in the use of meloxicam in rat model of osteoarthritis
  39. Attenuation of IL-1ß on the use of glucosamine as an adjuvant in meloxicam treatment in rat models with osteoarthritis
  40. Analysis of effectiveness and drug related problems of pain reliever for knee osteoarthritis: weighing clinical risk and benefit
  41. Comparison of antibiotic prescriptions in adults and children with upper respiratory tract infections in Bangka Tengah primary health care centers
  42. Profile of sociodemographics, sources of infection, antiretrovirals and CD4 counts on HIV/AIDS outpatients in Turen Primary Health Centre, Indonesia
  43. Synergistic anti-hepatitis C virus activity of Ruta angustifolia extract with NS3 protein inhibitor
  44. In vitro equivalence of generic and branded amoxicillin tablet by microbiological assay method
  45. Knowledge and attitude: two fundamental factors that determine patient compliance in antibiotic therapy
  46. Molecular docking study of sappan wood extract to inhibit PBP2A enzyme on methicillin-resistant Staphylococcus aureus (MRSA)
  47. Effect of curcumin analogue synthetic product from cullilawan oil for the liver damage treatment in male mice (Mus musculus L.)
  48. Case Report
  49. A case report of generalized tetanus in a 42-year-old man with dental infection
https://doi.org/10.1515/jbcpp-2019-0266
Schlagwörter für diesen Artikel
clopidogrel; coronary heart disease (CHD); omeprazole; P2Y12 reaction unit (PRU)

Artikel in diesem Heft

  1. Reviews
  2. Pharmacist contributions in the treatment of diabetes mellitus in Southeast Asia: a narrative review
  3. The implementation of a chronic disease management program (Prolanis) in Indonesia: a literature review
  4. Original Articles
  5. Quercetin attenuates acute predator stress exposure-evoked innate fear and behavioral perturbation
  6. Evaluating current practices and policies in the use of injectable medicines for treating myalgia in a primary care center in Pamekasan, Indonesia
  7. The contemporary role and potential of pharmacist contribution for community health using social media
  8. Evaluation of rational drug use based on World Health Organization prescribing indicators in a primary care center in Pamekasan East Java, Indonesia
  9. The prescription patterns of second-generation antipsychotics in schizophrenia outpatient setting
  10. Factors affecting community pharmacist’s service for women with chronic diseases during pregnancy and breastfeeding: application of the Health Belief Model
  11. Overview of therapeutic changes in antiepileptic drugs in adult patients
  12. Exploration of barriers affecting job satisfaction among community pharmacists
  13. Patients’ characteristics and their adherence to insulin therapy
  14. Correlation of chemotherapy costs with quality of life in nasopharyngeal cancer patients
  15. Impact of educational preeclampsia prevention booklet on knowledge and adherence to low dose aspirin among pregnant women with high risk for preeclampsia
  16. Translation, cultural adaptation, and validation of the quality of well being self-administered questionnaire in general population in Indonesia
  17. Knowledge, attitude, and practice of pharmacists towards management of hypertension in primary care centers
  18. Medication adherence in diabetes mellitus patients at Tanjung Karang Primary Health Care Center, Mataram
  19. Decreasing angiogenesis vasa vasorum through Lp-PLA2 and H2O2 inhibition by PSP from Ganoderma lucidum in atherosclerosis: in vivo diabetes mellitus type 2
  20. Antiaggregation effect of clopidogrel in coronary heart disease patients using omeprazole
  21. The effect of curcuma (Curcuma xanthorrizha roxb.) extract as an adjuvant of captopril therapy on cardiac histopathology of male mice (Mus musculus) with hypertension
  22. Coenzyme Q10 nanostructured lipid carriers as an inducer of the skin fibroblast cell and its irritability test in a mice model
  23. Medical problems in patients with chronic kidney disease undergoing hemodialysis and their therapy
  24. ADMET properties of novel 5-O-benzoylpinostrobin derivatives
  25. Development of nonalcoholic fatty liver disease model by high-fat diet in rats
  26. Molecular docking of novel 5-O-benzoylpinostrobin derivatives as wild type and L858R/T790M/V948R mutant EGFR inhibitor
  27. The relationship between the level of education and accuracy of insulin injection techniques in DM patients with measurement of HbA1c values
  28. The effect of premixed insulin to blood glucose concentration in patients with type 2 diabetes mellitus
  29. Intravenous insulin therapy in diabetes mellitus with hyperglycemic crisis and intercurrent illness
  30. Adherence behavior assessment of oral antidiabetic medication use: a study of patient decisions in long-term disease management in primary health care centers in Surabaya
  31. Evaluation to the chemotherapy use in patients with diffuse large B-cell lymphoma
  32. Analysis of the use and cost of stress ulcer prophylaxis for surgical inpatients
  33. Antineuroinflammation activity of n-butanol fraction of Marsilea crenata Presl. in microglia HMC3 cell line
  34. The enhancement of Arg1 and activated ERβ expression in microglia HMC3 by induction of 96% ethanol extract of Marsilea crenata Presl. leaves
  35. Ternary solid dispersion to improve solubility and dissolution of meloxicam
  36. Improving solubility and dissolution of meloxicam by solid dispersion using hydroxypropyl methylcellulose 2910 3 cps and nicotinamide
  37. o-Hydroxycinnamic derivatives as prospective anti-platelet candidates: in silico pharmacokinetic screening and evaluation of their binding sites on COX-1 and P2Y12 receptors
  38. The change of proinflammatory cytokine tumor necrosis factor α level in the use of meloxicam in rat model of osteoarthritis
  39. Attenuation of IL-1ß on the use of glucosamine as an adjuvant in meloxicam treatment in rat models with osteoarthritis
  40. Analysis of effectiveness and drug related problems of pain reliever for knee osteoarthritis: weighing clinical risk and benefit
  41. Comparison of antibiotic prescriptions in adults and children with upper respiratory tract infections in Bangka Tengah primary health care centers
  42. Profile of sociodemographics, sources of infection, antiretrovirals and CD4 counts on HIV/AIDS outpatients in Turen Primary Health Centre, Indonesia
  43. Synergistic anti-hepatitis C virus activity of Ruta angustifolia extract with NS3 protein inhibitor
  44. In vitro equivalence of generic and branded amoxicillin tablet by microbiological assay method
  45. Knowledge and attitude: two fundamental factors that determine patient compliance in antibiotic therapy
  46. Molecular docking study of sappan wood extract to inhibit PBP2A enzyme on methicillin-resistant Staphylococcus aureus (MRSA)
  47. Effect of curcumin analogue synthetic product from cullilawan oil for the liver damage treatment in male mice (Mus musculus L.)
  48. Case Report
  49. A case report of generalized tetanus in a 42-year-old man with dental infection
Jetzt anmelden und 20% sparen
Institutioneller Zugang
Wie funktioniert Authentifizierung?
Haben Sie eine Idee, wie wir unsere Website verbessern können?
Bitte schreiben Sie uns.
© 2025 De Gruyter Brill
Heruntergeladen am 12.9.2025 von https://www.degruyterbrill.com/document/doi/10.1515/jbcpp-2019-0266/html
Button zum nach oben scrollen