Proton pump inhibitors and antiplatelet drugs interactions from perspective of TRITON-TIMI 38 and PRINCIPLE-TIMI 44 trials Review article
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Abstract
The necessity of using by patients after acute coronary syndrome or/and percutaneous coronary intervention both aspirin and clopidogrel for 12 month sometimes with anticoagulant treatment (warfarin, acenocumarol) is associated with increased risk of haemorrhages . Proton pump inhibitors (PPI) are used in treatment or preventive treatment injury of tunica mucosa upper part of gastrointestinal tract associated with using aspirin or non-steroidal anti-inflammatory drug. However, several studies have raised concerns that many PPI’s might diminish the antiplatelet effects of thienopyridines (clopidogrel or prasugrel) because of being metabolized by the same metabolic path. The analysis of two trials TRITON-TIMI 38 and PRINCIPLE-TIMI 44 did not confirm this hypothesis. Further randomized trials are needed. Daily practice should be supported by experts recommendations.
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