Influence of omeprazole or famotidine on the clopidogrel and aspirin antiplatelet actions during dual-antiplatelet therapy in patients with coronary artery disease

YAN Zhe; DOU Ying; SUN Fu-cheng

doi:10.3760/cma.j.issn.1673-4777.2013.10.002

Abstract：Objective To investigate the influence of omeprazole or famotidine on the antiplatelet actions during dual-antiplatelet therapy(DAPT) in patients with coronary artery disease.Methods The patients underwent DAPT for coronary artery disease in our hospital from June 2011 to January 2013 were investigated.There were 223 patients with coronary artery disease.According to exclusion criteria,37 patients with DAPT were excluded.DAPT was conducted in 186 patients who underwent platelet aggregation function testing during the investigation period.66 patients were not given an antacid; concomitantly,the omeprazole (40 mg/d,ivgtt) was used in 88 patients ; 32 patients were given famotidine(20 mg,bid,po).100 mg/day of aspirin and 75 mg/day of clopidogrel were concomitantly used in all patients.Platelet aggregation rate and platelet aggregation threshold index (PATI) were measured.Results The ADP-PATI of control group,famotidine group and omeprazole group was (3.5 ± 1.0) μmol/L,(3.8 ±0.5)μmoL/L,(3.4 ± 0.9)μmoL/L,respectively.The collagen-PATI of control group,famotidine group,omeprazole group were (1.93 ± 0.25) mg/L,(1.99 ± 0.03) mg/L,(1.95 ± 0.16) mg/L,respectively.No statistically significant difference was observed regarding the ADP-PATI and collagen-PATI of respective groups compared to the control group(P ＞0.05).A signicicant difference was observed in platelet aggregation rate regarding the minimum concentration of collagen between the famotidine group and the control group [(7.1 ± 2.3) ％ vs (9.4 ±6.6) ％,P ＜ 0.05].There was also no statistically significant difference in the maximum platelet aggregation rate regarding the maximum concentration of ADP and collagen (P ＞ 0.05).Conclusion In patients with coronary artery disease,the concomitant use of omeprazole or famotidine does not affect antiplatelet action during DAPT.