Impact of proton pump inhibitors on the antiplatelet effects of clopidogrel

摘要

For patients undergoing coronary stent placement, dual antiplatelet therapy using aspirin and clopidogrel is the therapy of choice to prevent thrombosis of the treated vessels and subsequent ischemic events. Patients receiving this dual antiplatelet treatment are commonly treated with proton pump inhibitors (PPIs) in order to prevent gastric damage. However, although current guidelines recommend prescription of PPIs in all patients under dual antiplatelet treatment, platelet response to clopidogrel may be attenuated by this combination. Generally, platelet response to clopidogrel is highly variable and clinical, cellular, as well as genetic factors have been declared causative for a low-response to clopidogrel.