Effectsofomeprazoleorpantoprazoleonplateletfunctioninnon-ST-segmentelevationacutecoronarysyndromepatientsreceivingclopidogrel

摘要： Background:Thisstudyevaluatedtheeffectofomeprazoleorpantoprazoleonplateletreactivityinnon-STsegmentelevationacutecoronarysyndrome(NSTE-ACS)patientsreceivingclopidogrel.Methods:ConsecutivepatientswithNSTE-ACS(n=620)fromgeneralhospitalofShenyangMilitaryCommandwererandomizedtotheomeprazoleorpantoprazole(20mg/d)group(1:1),andreceivedroutinedualantiplatelettreatment.Patientsreversionrateofadenosinediphosphate-inducedplateletaggregation(ADP-PA)wasassessedatbaseline,12to24hafteradministrationofmedication,andafter72hofpercutaneouscoronaryintervention(PCI).TheprimaryendpointofthestudywasplateletreactivityassessedwithADP-PAat30daysafterPCI.Adverseevents(AEs)wererecordedfor30-dayand180-dayfollow-upperiods.Results:Therewerenosignificantdifferencesbetweenboththegroupsinplateletresponsetoclopidogrelat12–24hafterdrugadministration(54.09%±18.90%vs.51.62%±19.85%,P=0.12),72hafterPCI(52.15%±19.45%vs.49.66%±20.05%,P=0.18),and30daysafterPCI(50.44%±14.54%vs.48.52%±15.08%,P=0.17).TherateofAEsdidnotdiffersignificantlybetweengroupsduringthe30-day(15.2%vs.14.8%,P=0.91)and180-day(16.5%vs.14.5%,P=0.50)follow-upperiodsafterPCI.Conclusion:Theadditionofomeprazoleorpantoprazoletoclopidogreldidnotrestricttheeffectofplateletaggregationbyreducingtheconversionofclopidogrel.Comparedwithclopidogrelalone,pantoprazole-clopidogrelandomeprazoleclopidogrelcombinationsdidnotincreasetheincidenceofadverseclinicaleventsduring30-dayand180-dayfollow-upperiodsafterPCI. ... （共10頁）