Objectives: Controversy has been prompted based on drug interaction
between proton pump inhibitors (PPIs) and aspirin/clopidogrel leading to
weakened effects. However, whether such interaction was drug-specific or
class effect remains controversial. This study predicted the impact of esomeprazole
and rabeprazole on efficacy of dual antiplatelet therapy (DAPT).
Methods: This study, involving 150 patients, evaluated the efficacy of DAPT
upon concomitant use of esomeprazole (40 mg/d) or rabeprazole (20 mg/d).
Platelet reactivity was assessed by value of ADP-induced light transmittance
aggregometry (LTA) and vasodilator-stimulated phosphoprotein phosphorylation-
platelet reactivity index (VASP-PRI) at day 1, day 3 and day 30 end
points after initiation of DAPT.
Results: No significance were observed by post-hoc analysis of treatment-byperiod
interaction in LTA value and VASP-PRI value when compared with
non-PPI users, which suggests no carryover effect in both PPIs over the 30-day
treatment period. Moreover, no statistical differences was in LTA or VASP-PRI
value in esomeprazole group while rabeprazole group showed decreased in
antiplatelet function of DAPT at the day 3 and day 30 end points.
Conclusion: Although antiplatelet effect of DAPT were not affected upon
concomitant use of both PPIs over the 30-day treatment period, esomeprazole
exerts much more stable impact on antiplatelet effect than rabeprazole
among respective end points.