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- W1979048232 abstract "Background: Although gastric acid-suppressing therapy is needed to attenuate GI bleeding during antiplatelet therapy, several regimens increase the risk of high on-clopidogrel platelet reactivity (HPR). PPI-clopidogrel interaction appears less evident following rabeprazole than omeprazole. This randomized study aimed to compare the effect of rabeprazole and famotidine on clopidogrel response and the risk of HPR. Methods: Elective PCI-treated patients without HPR were randomized to receive rabeprazole 20 mg daily (n=39) or famotidine 40 mg daily (n = 39). Platelet reactivity was measured at baseline and on day 14 by conventional aggregometry and VASP-P assay. Primary endpoint was 5 μM ADP-induced platelet aggregation (PA) at follow-up. HPR was defined as 5 μM ADP-PA > 46%. Results: Baseline platelet measurements did not differ significantly between the groups. The level of 5 μM ADP-PA on day 14 was similar between the rabeprazole vs. famotidine group (30.2±13.9% vs. 30.0±16.4%, p = 0.956). Other platelet measures including VASP-PRI were also comparable. However, compared with baseline values, follow-up ADP-induced platelet measures were increased by rabeprazole (difference, 7.8%; 95% CI, 2.8-12.7%; p = 0.003) or famotidine (difference, 5.4%; 95% CI, 1.5-9.4%; p = 0.008) co-administration. Furthermore, the risk of HPR was also increased at follow-up (35.9% by rabeprazole and 28.2% by famotidine, respectively). Arachidonic acid- and collagen-induced PAs were similar between baseline and follow-up in both groups. Conclusions: In elective PCI-treated patients, adjunctive rabeprazole and famotidine showed the similar level of platelet reactivity during clopidogrel treatment. When considering GI protective effect and interaction with clopidogrel response together, H2R blocker famotidine may not substitute the position of PPI having low inhibition for CYP2C19 activity." @default.
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- W1979048232 date "2013-08-02" @default.
- W1979048232 modified "2023-09-23" @default.
- W1979048232 title "Effect of rabeprazole versus famotidine on platelet inhibition in patients with normal clopidogrel responsiveness: result of the ACCEL-PROTECT randomized study" @default.
- W1979048232 doi "https://doi.org/10.1093/eurheartj/eht310.p4910" @default.
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