{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T16:39:16Z","timestamp":1771519156714,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,4,29]],"date-time":"2013-04-29T00:00:00Z","timestamp":1367193600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Concerns about an inhibitory effect of proton pump inhibitors (<jats:styled-content style=\"fixed-case\">PPIs<\/jats:styled-content>) on clopidogrel metabolism have been raised. Because the pharmacological effect of clopidogrel is dependent on genetically determined activity of the hepatic cytochrome <jats:styled-content style=\"fixed-case\">P450<\/jats:styled-content> isoenzymes system, it is important to examine the interaction between different <jats:styled-content style=\"fixed-case\">PPIs<\/jats:styled-content> and high on\u2010treatment platelet reactivity (<jats:styled-content style=\"fixed-case\">HPR<\/jats:styled-content>) after controlling for genetic variability. The aim of the study was to assess the effect of 2 <jats:styled-content style=\"fixed-case\">PPIs<\/jats:styled-content> and a histamine\u20102 (<jats:styled-content style=\"fixed-case\">H2<\/jats:styled-content>) receptor\u2010blocker on platelet reactivity in a crossover trial where each patient was alternately treated with each drug.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Omeprazole reduces HPR more than other PPI or H<jats:sub>2<\/jats:sub> blockers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients treated with aspirin and clopidogrel for at least 1 month were assigned to 3 consecutive 1\u2010month treatment periods during which they were treated with each of the 3 study medications twice daily: omeprazole 20 mg, famotidine 40 mg, and pantoprazole 20 mg. At the end of each treatment phase, platelet function was evaluated with the Verify Now system using 2 cutoff values (&gt;208 <jats:styled-content style=\"fixed-case\">P2Y12<\/jats:styled-content> reaction units [<jats:styled-content style=\"fixed-case\">PRUs<\/jats:styled-content>] and &gt;230 <jats:styled-content style=\"fixed-case\">PRUs<\/jats:styled-content>) for the definition of <jats:styled-content style=\"fixed-case\">HPR<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with <jats:styled-content style=\"fixed-case\">HPR<\/jats:styled-content> were older than those without <jats:styled-content style=\"fixed-case\">HPR<\/jats:styled-content> (62 \u00b1 10 vs 55 \u00b1 8 years, respectively, P = 0.03). <jats:styled-content style=\"fixed-case\">HPR<\/jats:styled-content> was more prevalent during omeprazole therapy compared to famotidine or pantoprazole (48%, 33%, and 31%, respectively, for the 208 <jats:styled-content style=\"fixed-case\">PRU<\/jats:styled-content> cutoff, P= 0.04; and 37%, 17%, and 23%, respectively, for the 230 <jats:styled-content style=\"fixed-case\">PRU<\/jats:styled-content> cutoff, P= 0.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>After eliminating the effects of interindividual variability in clopidogrel metabolism, omeprazole therapy was associated with substantially more <jats:styled-content style=\"fixed-case\">HPR<\/jats:styled-content> than famotidine or pantoprazole.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22117","type":"journal-article","created":{"date-parts":[[2013,4,29]],"date-time":"2013-04-29T13:50:43Z","timestamp":1367243443000},"page":"342-346","source":"Crossref","is-referenced-by-count":30,"title":["Platelet Inhibitory Effect of Clopidogrel in Patients Treated With Omeprazole, Pantoprazole, and Famotidine: A Prospective, Randomized, Crossover 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