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Impact of Rabeprazole on APO-Dabigatran Exposure in Healthy Volunteers
CONCLUSIONS: When APO-dabigatran is administered with rabeprazole, the exposure to dabigatran is reduced by about 30%, which is similar to the level observed with Pradaxa when it was co-administered with a proton pump inhibitor. However, the finding that one-third of participants had a > 50% reduction in exposure is concerning, and it highlights the need for caution in patients who have, or are at risk of, reduced gastric acidity.PMID:36700178 | PMC:PMC9869351 | DOI:10.1016/j.cjco.2022.09.006
Source: Atherosclerosis - January 26, 2023 Category: Cardiology Authors: Noel Chan Matt Wheeler Vinai Bhagirath Jacqueline Bosch Jutta Heinrich-Nols Debbie Sloane Joanne van Ryn Linda Jefferies Jacqueline Wilkinson Qilong Yi John Eikelboom Source Type: research

Proton Pump Inhibitors and Dabigatran Therapy: Impact on Gastric Bleeding and Dabigatran Plasma Levels
This article reviews up to date data about the risk of gastric bleeding on dabigatran, the impact of PPI on the reduction of gastric bleeding, and the interaction between PPI and dabigatran leading to decreased dabigatran plasma levels. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Seminars in Thrombosis and Hemostasis - September 18, 2019 Category: Hematology Authors: Bolek, Tom áš Samo š, Matej Škorňová, Ingrid Galajda, Peter Sta ško, Ján Kubisz, Peter Mok áň, Marián Tags: Review Article Source Type: research

Efficacy and safety of clopidogrel only vs. clopidogrel added proton pump inhibitors in the treatment of patients with coronary heart disease after percutaneous coronary intervention: A systematic review and meta-analysis
ConclusionsThe patients in the non-PPI group were observed to be associated with less risk of MACE, myocardial infarction recurrence, stent thrombosis, target vessel revascularization (TVR) and stroke. And the two groups had similar all cause death, cardiovascular death, bleedings events.
Source: IJC Heart and Vasculature - April 2, 2019 Category: Cardiology Source Type: research

Anticoagulation in Atherosclerotic Disease.
Abstract The prevention of atherothrombotic events is an essential therapeutic goal in the treatment of patients with arteriosclerotic diseases. After plaque rupture, a rapidly growing thrombus can lead to acute vascular occlusion and thus heart attack, stroke or limb ischaemia. The acute therapy combines anticoagulation and platelet inhibition. However, the only available therapy so far in the primary and secondary prevention of stable patients is the platelet inhibitors aspirin and clopidogrel. Despite the use of antiplatelet therapies, including aspirin and P2Y12-receptor antagonists, some patients with artery ...
Source: Hamostaseologie - October 17, 2018 Category: Hematology Authors: Al Said S, Bode C, Duerschmied D Tags: Hamostaseologie Source Type: research

Dabigatran in patients with myocardial injury after non-cardiac surgery (MANAGE): an international, randomised, placebo-controlled trial
Publication date: 9–15 June 2018 Source:The Lancet, Volume 391, Issue 10137 Author(s): P J Devereaux, Emmanuelle Duceppe, Gordon Guyatt, Vikas Tandon, Reitze Rodseth, Bruce M Biccard, Denis Xavier, Wojciech Szczeklik, Christian S Meyhoff, Jessica Vincent, Maria Grazia Franzosi, Sadeesh K Srinathan, Jason Erb, Patrick Magloire, John Neary, Mangala Rao, Prashant V Rahate, Navneet K Chaudhry, Bongani Mayosi, Miriam de Nadal, Pilar Paniagua Iglesias, Otavio Berwanger, Juan Carlos Villar, Fernando Botto, John W Eikelboom, Daniel I Sessler, Clive Kearon, Shirley Pettit, Mukul Sharma, Stuart J Connolly, Shrikant I Bangdiwala, ...
Source: The Lancet - June 8, 2018 Category: General Medicine Source Type: research

Impact of Proton-pump Inhibitors on the Pharmacodynamic Effect and Clinical Outcomes in Patients Receiving Dual Antiplatelet Therapy after Percutaneous Coronary Intervention: A Propensity Score Analysis.
CONCLUSION: In this large cohort of real-world patients, the combination of PPIs with DAPT was not associated with increased risk of MACCE in patients who underwent PCI at up to 2 years of follow-up. PMID: 29237921 [PubMed - in process]
Source: Chinese Medical Journal - December 15, 2017 Category: General Medicine Authors: Zhu P, Gao Z, Tang XF, Xu JJ, Zhang Y, Gao LJ, Chen J, Qiao SB, Yang YJ, Gao RL, Xu B, Yuan JQ Tags: Chin Med J (Engl) Source Type: research

Conflicting Results Between Randomized Trials and Observational Studies on the Impact of Proton Pump Inhibitors on Cardiovascular Events When Coadministered With Dual Antiplatelet Therapy: Systematic Review Original Articles
Conclusions— Large, well-conducted observational studies of PPIs and randomized controlled trials of omeprazole seem to provide conflicting results for the effect of PPIs on cardiovascular outcomes when coadministered with DAPT. Prospective trials that directly compare pharmacodynamic parameters and clinical events among specific PPI agents in patients with unstable angina/non–ST-segment–elevation myocardial infarction treated with DAPT are warranted.
Source: Circulation: Cardiovascular Quality and Outcomes - January 20, 2015 Category: Cardiology Authors: Melloni, C., Washam, J. B., Jones, W. S., Halim, S. A., Hasselblad, V., Mayer, S. B., Heidenfelder, B. L., Dolor, R. J. Tags: Secondary prevention Original Articles Source Type: research

Analysis of gastrointestinal prophylaxis in patients receiving dual antiplatelet therapy with aspirin and clopidogrel.
CONCLUSION: More than half of the patients did not receive GI prophylaxis appropriately. The most common reason for nonadherence to the consensus document was no prophylaxis when indicated. Vascular events could not be directly attributed to PPI use, and GI events occurred despite prophylaxis. Overall, there was a low incidence of adverse events related to the use of PPI therapy.  PMID: 24456320 [PubMed - indexed for MEDLINE]
Source: Journal of Managed Care Pharmacy - November 14, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research