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It is well established that some individuals have a diminished response to clopidogrel therapy; however, the mechanisms of the impairment are unclear and appear to be multifactorial. In this double-blind, placebo-controlled trial, investigators in France sought to determine whether the metabolism of omeprazole by a cytochrome P450 isoenzyme could competitively inhibit the activation of clopidogrel by the same isoenzyme. The researchers calculated a platelet-reactivity index (PRI) by measuring platelet vasodilator-stimulated phosphoprotein, a key measure of the inhibitory effect of clopidogrel on platelet activation.
A total of 140 patients receiving clopidogrel (300 mg loading dose, then 75 mg daily) after stent implantation were randomized …