Does Proton-Pump Inhibitor Use Reduce the Antiplatelet Effects of Low-Dose Aspirin?

Apparently yes, but the effect on cardiovascular outcomes is not yet known.

Proton-pump inhibitors (PPIs) have been shown to reduce the antiplatelet effects of clopidogrel in patients who take this thienopyridine after an acute coronary syndrome event, but adverse effects on cardiovascular outcomes have not been demonstrated (JW Gastroenterol Oct 16 2009). Now, researchers from Denmark have conducted a case-control study of platelet function in 418 adults with stable coronary artery disease who were taking 75 mg/day of aspirin; 54 were also on a PPI (the majority on pantoprazole).

Compared with PPI nonusers, those taking a PPI had significantly higher platelet aggregation (P=0.003); higher serum levels of soluble P-selectin, a cell-adhesion molecule stored in the alpha granules of platelets (P=0.005); and higher ser…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors