JACC: Heartburn drug decreases antiplatelet drug efficacy

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A dual therapeutic model is getting a second look as new research confirms the combo has unintended effects. 

Martine Gilard, MD, of the department of cardiology, and colleagues at the Brest University Hospital in Brest, France conducted a study to assess the influence of omeprazole on clopidogrel.

Clopidogrel has proved its benefit in the treatment of atherothrombotic diseases. Clopidogral and aspirin antiplatelet therapy are widely prescribed along with proton pump inhibitors (PPIs) such as omeprazole to prevent gastrointestinal bleeding.

In a double-blind placebo-controlled trial, all 124 consecutive patients undergoing coronary artery stent implantation received aspirin (75 mg/day) and clopidogrel (loading dose, followed by 75 mg/day). They were then randomized to receive either associated omeprazole (20 mg/day) or placebo for seven days.

They found that omeprazole (Prilosec, AstraZeneca) significantly diminished the platelet inhibitory effect of clopidogrel (Plavix, Bristol-Myers Squibb). The study appeared in the Jan. 15 issue of the Journal of the American College of Cardiology.