Effect of esomeprazole on clopidogrel-induced platelet inhibition

Objective To investigate the effect of esomeprazole on platelet inhibition induced by clopidogrel.Methods Response to clopidogrel was assessed by the vasodilator-agent stimulated phosphoprotein(VASP) assay and aggregometry(multiplate analyzer) in 151 patients with coronary artery disease(CAD) undergoing percutaneous coronary intervention(PCI).All patients received a clopidogrel loading dose(600 mg) at the start of clopidogrel treatment.Patients had been treated with clopidogrel(75 mg·d-1) and aspirin(100 mg·d-1) for 3 months on average(5 days at least).Esomeprazole was used in the study.Results The mean platelet reactivity index(PRI,assessed by the VAS Passay)was nearly the same in patients with esomeprazole(n=76;PRI = 54%) or in the control group(n=75;PRI = 49%;P=0.718).There was no difference in the PRI or the adenosine diphosphate-induced platelet aggregation between patients with esomeprazole(n=76;PRI=54%;aggregation=42 U),or patients without PPI(n=75;PRI=49%;aggregation=41 U;P=0.373).Conclusion Doctors had better choose esomeprazole with a small interaction to treat patients who received clopidogrel therapy and acid suppression intervention when needing PPI treatment.