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In response to conflicting results of recent studies (JW Cardiol Mar 3 2009), regulatory agencies have issued warnings about the possible risks of combining a thienopyridine with a proton-pump inhibitor (PPI), leaving many clinicians perplexed about how best to treat patients who are at risk for both thrombotic events and gastrointestinal bleeding. To assess whether PPI use might influence measures of platelet function and clinical outcomes in patients treated with clopidogrel or prasugrel, these investigators conducted a retrospective analysis of data from two randomized trials.
In PRINCIPLE-TIMI 44, a double-blind, two-phase crossover study, 201 patients scheduled to undergo percutaneous coronary intervention were randomized to receive eit…