Influence of Omeprazole and Famotidine on the Antiplatelet Effects of Clopidogrel in Addition to Aspirin in Patients With Acute Coronary Syndromes

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概要

• 論文の詳細を見る

• Background: It remains unclear whether concomitant use of omeprazole attenuates platelet function as compared with that of famotidine in patients with acute coronary syndromes (ACS) who receive clopidogrel. Methods and Results: In this prospective study, 130 ACS patients treated with aspirin and clopidogrel who underwent stent implantation were randomly assigned to receive a Japanese standard dose of omeprazole 10mg daily or famotidine 20mg daily for at least 4 weeks. Between 14 and 28 days after enrollment, there was no significant difference in the platelet reactivity index (PRI) measured with vasodilator-stimulated phosphoprotein phosphorylation assay between the omeprazole group (n=65) and famotidine group (n=65) (55±17% vs. 51±19%; P=0.26). The cumulative rate of adverse cardiovascular events at 12 months was similar in the groups (13% vs. 17%; P=0.81). The PRI was similar (54.9±17.9% vs. 54.0±17.8%; P=0.83) in the omeprazole group (n=33) and the famotidine group (n=39) among patients with ST-elevation myocardial infarction (STEMI). However, there was a trend toward a higher PRI (55.2±15.9% vs. 46.4±19.4%; P=0.06) in the omeprazole group (n=32) as compared with the famotidine group (n=26) among patients without persistent ST-segment elevation ACS. Conclusions: As compared with famotidine, concomitant use of low-dose omeprazole does not significantly attenuate the antiplatelet effects of clopidogrel in patients with ACS, especially in those with STEMI.  (Circ J 2012; 76: 2673–2680)

著者

• KIMURA Kazuo

  Division of Cardiology, Yokohama City University Medical Center

• SUGANO Teruyasu

  Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine

• Yano Hideto

  Division of Cardiology, Fujisawa City Hospital

• Tsukahara Kengo

  Division Of Cardiology Yokohama City University Medical Center

• Hibi Kiyoshi

  Division Of Cardiology Yokohama City University Medical Center

• Himeno Hideo

  Division Of Cardiology Fujisawa City Hospital

• Yano Hideto

  Division Of Cardiology Fujisawa City Hospital

• Kimura Kazuo

  Division Of Cardiology Yokohama City University Medical Center

• Fukui Kazuki

  Division Of Cardiology Kanagawa Cardiovascular Respiratory Center

• Umemura Satoshi

  Department Of Internal Medicine Ii Yokohama City University School Of Medicine

• Sugano Teruyasu

  Department Of Cardiology Yokohama City University Hospital

• ENDO Tsutomu

  Division of Cardiology, Saiseikai Yokohama City Southern Hospital

• Hibi Kiyoshi

  Division of Cardiology, Yokohama City University Medical Center

• MORITA Satoshi

  Department of Biostastics and Epidemiology, Yokohama City University Medical Center

• MORITA Satoshi

  Department of Biostatistics and Epidemiology, Yokohama City University School of Medicine and University Medical Center

• UMEMURA Satoshi

  Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine

• FUKUI Kazuki

  Division of Cardiology, Kanagawa Cardiovascular and Respiratory Disease Center

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