Clopidogrel and proton pump inhibitors: Are the goal posts shifting?

摘要

Modern treatment of acute coronary syndrome involves reducing platelet activity. Currently this is achieved orally by generally targeting 2 pathways of platelet activation, the cyclooxygenase pathway, with aspirin and the ADP receptor, most commonly with clopidogrel. This leads to a reduction in death from cardiovascular causes, non fatal myocardial infarction and stroke in both patients treated with medical therapy and in those undergoing percutaneous coronary angioplasty [1,2]. Any impact of reducing the efficacy of such antiplatelet therapies may lead to potentially worse outcomes in coronary patients. Therefore any drug-drug interaction that impairs antiplatelet drug efficacy should be avoided.