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Thromb Haemost 2010; 104(06): 1211-1218
DOI: 10.1160/TH10-04-0218
Platelets and Blood Cells
Schattauer GmbH

Impact of concomitant treatment with proton pump inhibitors and clopidogrel on clinical outcome in patients after coronary stent implantation

Ioannis Tentzeris
1   3rd Medical Department with Cardiology and Emergency Medicine, Wilhelminen Hospital, Vienna, Austria
,
Rudolf Jarai
1   3rd Medical Department with Cardiology and Emergency Medicine, Wilhelminen Hospital, Vienna, Austria
,
Serdar Farhan
1   3rd Medical Department with Cardiology and Emergency Medicine, Wilhelminen Hospital, Vienna, Austria
,
Ivan Brozovic
1   3rd Medical Department with Cardiology and Emergency Medicine, Wilhelminen Hospital, Vienna, Austria
,
Peter Smetana
1   3rd Medical Department with Cardiology and Emergency Medicine, Wilhelminen Hospital, Vienna, Austria
,
Alexander Geppert
1   3rd Medical Department with Cardiology and Emergency Medicine, Wilhelminen Hospital, Vienna, Austria
,
Johann Wojta
2   Department of Cardiology, Medical University of Vienna, Vienna, Austria
,
Jolanta Siller-Matula
3   Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
,
Kurt Huber
1   3rd Medical Department with Cardiology and Emergency Medicine, Wilhelminen Hospital, Vienna, Austria
› Author Affiliations
Further Information

Publication History

Received: 07 April 2010

Accepted after major revision: 20 August 2010

Publication Date:
24 November 2017 (online)

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Summary

The aim of the study was to evaluate the effect of the concomitant treatment with proton-pump inhibitors (PPIs) and clopidogrel on the incidence of stent thrombosis, acute coronary syndrome (ACS) and death in patients who underwent percutaneous coronary intervention (PCI) and stent implantation. In total, 1,210 patients under dual anti-platelet therapy, who underwent PCI and stent implantation, were included in a prospective registry from January 2003 until December 2006. The patients were divided retrospectively into those with or without long-term PPI treatment (for the duration of dual antiplatelet therapy). All-cause mortality, cardiovascular death, re-hospitalisation for reACS, stent thrombosis, as well as the combined endpoint all-cause death, re-ACS or stent thrombosis were evaluated over a mean follow-up period of 7.8 (± 3.63) months (range 1–12 months). Propensity score analysis was performed to reduce potential selection bias and exhibited no significant difference between the two study groups with respect to all-cause mortality, cardiovascular death, re-ACS, stent thrombosis and the combined endpoint. In pre-specified subgroup analyses performed in patients presenting with ACS and referred for acute PCI or for stable patients referred for elective PCI, receiving drug-eluting stents or bare metal stents, in diabetics or non-diabetics, in males or females, and in patients older than 75 years or ≤75 years of age use of PPIs had no significant impact on clinical outcome. Our data suggest that a combined use of clopidogrel as part of dual antiplatelet therapy (DAPT) after coronary stenting and PPIs does not significantly influence the clinical outcome.

Keywords

Stent implantation - clopidogrel - proton pump inhibitors - acute coronary syndrome - stent thrombosis
 

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