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Ilaprazole and Clopidogrel Resistance in Acute Stroke Patients

Clopidogrel, an antiplatelet agent used for secondary prevention of cerebrovascular diseases, is often taken with proton pump inhibitors (PPIs). Generally, the combined use of clopidogrel and PPIs causes adverse drug–drug interactions. VerifyNow is a quick and convenient method to confirm clopidogre...

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Autores principales: Lim, In Hwan, Lee, Seung Jae, Shin, Byoung-Soo, Kang, Hyun Goo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9219695/
https://www.ncbi.nlm.nih.gov/pubmed/35740386
http://dx.doi.org/10.3390/biomedicines10061366
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author Lim, In Hwan
Lee, Seung Jae
Shin, Byoung-Soo
Kang, Hyun Goo
author_facet Lim, In Hwan
Lee, Seung Jae
Shin, Byoung-Soo
Kang, Hyun Goo
author_sort Lim, In Hwan
collection PubMed
description Clopidogrel, an antiplatelet agent used for secondary prevention of cerebrovascular diseases, is often taken with proton pump inhibitors (PPIs). Generally, the combined use of clopidogrel and PPIs causes adverse drug–drug interactions. VerifyNow is a quick and convenient method to confirm clopidogrel resistance (CR), which compromises adequate antithrombotic effects. We aimed to confirm CR, identify its factors, and determine the influence of the combination of ilaprazole and clopidogrel on clopidogrel using VerifyNow. In this retrospective study, we examined patients who were receiving clopidogrel after three months, starting within one week from the onset of cerebral infarction symptoms. Clinical records, imaging records, and diagnostic laboratory results, including P2Y12 reaction units (PRU), were compared and analyzed to check for CR. Additionally, the groups treated with either both ilaprazole and clopidogrel or with medications other than ilaprazole were comparatively analyzed. CR was defined as a PRU ≥240 after clopidogrel for three months. Among factors influencing CR by affecting clopidogrel metabolism, positive statistical correlations with age and alcohol consumption were confirmed. The diagnostic tests revealed a lower glomerular filtration rate and platelet count of the CR-positive group. This finding proved that the combination therapy of ilaprazole and clopidogrel is safe, as it does not interfere with the metabolism of clopidogrel.
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spelling pubmed-92196952022-06-24 Ilaprazole and Clopidogrel Resistance in Acute Stroke Patients Lim, In Hwan Lee, Seung Jae Shin, Byoung-Soo Kang, Hyun Goo Biomedicines Article Clopidogrel, an antiplatelet agent used for secondary prevention of cerebrovascular diseases, is often taken with proton pump inhibitors (PPIs). Generally, the combined use of clopidogrel and PPIs causes adverse drug–drug interactions. VerifyNow is a quick and convenient method to confirm clopidogrel resistance (CR), which compromises adequate antithrombotic effects. We aimed to confirm CR, identify its factors, and determine the influence of the combination of ilaprazole and clopidogrel on clopidogrel using VerifyNow. In this retrospective study, we examined patients who were receiving clopidogrel after three months, starting within one week from the onset of cerebral infarction symptoms. Clinical records, imaging records, and diagnostic laboratory results, including P2Y12 reaction units (PRU), were compared and analyzed to check for CR. Additionally, the groups treated with either both ilaprazole and clopidogrel or with medications other than ilaprazole were comparatively analyzed. CR was defined as a PRU ≥240 after clopidogrel for three months. Among factors influencing CR by affecting clopidogrel metabolism, positive statistical correlations with age and alcohol consumption were confirmed. The diagnostic tests revealed a lower glomerular filtration rate and platelet count of the CR-positive group. This finding proved that the combination therapy of ilaprazole and clopidogrel is safe, as it does not interfere with the metabolism of clopidogrel. MDPI 2022-06-09 /pmc/articles/PMC9219695/ /pubmed/35740386 http://dx.doi.org/10.3390/biomedicines10061366 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lim, In Hwan
Lee, Seung Jae
Shin, Byoung-Soo
Kang, Hyun Goo
Ilaprazole and Clopidogrel Resistance in Acute Stroke Patients
title Ilaprazole and Clopidogrel Resistance in Acute Stroke Patients
title_full Ilaprazole and Clopidogrel Resistance in Acute Stroke Patients
title_fullStr Ilaprazole and Clopidogrel Resistance in Acute Stroke Patients
title_full_unstemmed Ilaprazole and Clopidogrel Resistance in Acute Stroke Patients
title_short Ilaprazole and Clopidogrel Resistance in Acute Stroke Patients
title_sort ilaprazole and clopidogrel resistance in acute stroke patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9219695/
https://www.ncbi.nlm.nih.gov/pubmed/35740386
http://dx.doi.org/10.3390/biomedicines10061366
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