Skip to main content
Erschienen in: Der Kardiologe 5/2010

01.10.2010 | Positionspapier

Gleichzeitige Anwendung von Thrombozytenaggregationshemmern und Protonenpumpeninhibitoren (PPIs)

Positionspapier der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Kardiologie (DGK)

verfasst von: Prof. Dr. W. Fischbach, H. Darius, M. Gross, H. Koop, I. Kruck, K.U. Petersen

Erschienen in: Die Kardiologie | Ausgabe 5/2010

Einloggen, um Zugang zu erhalten

Zusammenfassung

Thrombozytenaggregationshemmer wie Protonenpumpeninhibitoren (PPIs) gehören zu den am weitesten verbreiteten Medikamenten. Die Therapie der koronaren Herzkrankheit (KHK) basiert neben interventionellen und chirurgischen Maßnahmen wesentlich auf der medikamentösen Hemmung der Plättchenaggregation mittels ASS und P2Y12-Inhibitoren. Dem positiven Nutzen dieser Medikamente stehen ihre gastrointestinalen Risiken gegenüber, die im Wesentlichen in gastroduodenalen Ulzera und möglichen Blutungskomplikationen bestehen. PPIs können diese signifikant reduzieren und wurden bei der dualen Plättchenhemmung als Begleitmedikation empfohlen. In den letzten beiden Jahren wurde indessen über eine mögliche Interaktion von Clopidogrel und PPIs berichtet, die zu intensiven Diskussionen geführt hat. Angesichts der Heterogenität der Studienergebnisse und der großen klinischen Bedeutung dieses Themas haben die Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten und die Deutsche Gesellschaft für Kardiologie ein Positionspapier verabschiedet, das klare Empfehlungen zum Umgang mit diesen Substanzen ausspricht. Sie basieren auf dem individuellen kardiovaskulären und gastrointestinalen Risiko.
Literatur
1.
Zurück zum Zitat Fischbach W, Malfertheiner P, Hoffmann JC et al (2009) S3-Leitlinie „Helicobacter pylori und gastroduodenale Ulkuskrankheit“ der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS) in Zusammenarbeit mit der Deutschen Gesellschaft für Hygiene und Mikrobiologie, Gesellschaft für Pädiatrische Gastroenterologie und Ernährung e.V. und der Deutschen Gesellschaft für Rheumatologie – AWMF-Register-Nr. 021/001. Z Gastroenterol 47:68–102CrossRefPubMed Fischbach W, Malfertheiner P, Hoffmann JC et al (2009) S3-Leitlinie „Helicobacter pylori und gastroduodenale Ulkuskrankheit“ der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS) in Zusammenarbeit mit der Deutschen Gesellschaft für Hygiene und Mikrobiologie, Gesellschaft für Pädiatrische Gastroenterologie und Ernährung e.V. und der Deutschen Gesellschaft für Rheumatologie – AWMF-Register-Nr. 021/001. Z Gastroenterol 47:68–102CrossRefPubMed
2.
Zurück zum Zitat Bhatt DL, Scheiman J, Abraham NS et al (2008) ACCF/ACG/AHA 2008 Expert Consensus Document on Reducing the Gastrointestinal Risks of Antiplatelet Therapy and NSAID Use: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Circulation 118:1894–1909CrossRefPubMed Bhatt DL, Scheiman J, Abraham NS et al (2008) ACCF/ACG/AHA 2008 Expert Consensus Document on Reducing the Gastrointestinal Risks of Antiplatelet Therapy and NSAID Use: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Circulation 118:1894–1909CrossRefPubMed
3.
Zurück zum Zitat Kushner FG, Hand M, Smith SC et al (2009) Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update). A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation published online Nov 18, 2009; DOI:10.1161/CIRCULATIONAHA.109.192663 Kushner FG, Hand M, Smith SC et al (2009) Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update). A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation published online Nov 18, 2009; DOI:10.1161/CIRCULATIONAHA.109.192663
4.
Zurück zum Zitat US Food and Drug Administration (2009) Early communication about an ongoing safety review of clopidogrel bisulfate (marketed as Plavix). http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafety/ucm079520.htm US Food and Drug Administration (2009) Early communication about an ongoing safety review of clopidogrel bisulfate (marketed as Plavix). http://​www.​fda.​gov/​Drugs/​DrugSafety/​PostmarketDrugSa​fety/​ucm079520.​htm
5.
Zurück zum Zitat European Medicines Agency (2009) Public statement on possible interaction between clopidogrel and proton pump inhibitors. http://www.emea.europa.eu/humandocs/PDFs/EPAR/Plavix/32895609en.pdf European Medicines Agency (2009) Public statement on possible interaction between clopidogrel and proton pump inhibitors. http://​www.​emea.​europa.​eu/​humandocs/​PDFs/​EPAR/​Plavix/​32895609en.​pdf
6.
Zurück zum Zitat US Food and Drug Administration. Public Health Advisory: Updated safety information about a drug interaction between clopidogrel bisulfate (marketed as Plavix) and omeprazole (marketed as Prilosec and Prilosec OTC). http://www.fda.gov/ Drugs/DrugSafety/PublicHealthAdvisories/ucm190825.htm US Food and Drug Administration. Public Health Advisory: Updated safety information about a drug interaction between clopidogrel bisulfate (marketed as Plavix) and omeprazole (marketed as Prilosec and Prilosec OTC). http://​www.​fda.​gov/​ Drugs/DrugSafety/PublicHealthAdvisories/ucm190825.htm
7.
Zurück zum Zitat The Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators (2001) Effects of clopidogrel to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 345(7):494–502CrossRef The Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators (2001) Effects of clopidogrel to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 345(7):494–502CrossRef
8.
Zurück zum Zitat Sabatine MS, Cannon CP, Gibson CM et al (2005) Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation. N Engl J Med 352(12):1179–1189CrossRefPubMed Sabatine MS, Cannon CP, Gibson CM et al (2005) Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation. N Engl J Med 352(12):1179–1189CrossRefPubMed
9.
Zurück zum Zitat Matetzky S, Shenkman B, Guetta V et al (2004) Clopidogrel resistance is associated with increased risk of recurrent atherothrombotic events in patients with acute myocardial infarction. Circulation 109:3171–3175CrossRefPubMed Matetzky S, Shenkman B, Guetta V et al (2004) Clopidogrel resistance is associated with increased risk of recurrent atherothrombotic events in patients with acute myocardial infarction. Circulation 109:3171–3175CrossRefPubMed
10.
Zurück zum Zitat Wiviott SD, Antman EM (2004) Clopidogrel resistance. A new chapter in a fast-moving story. Circulation 109:3064–3067CrossRefPubMed Wiviott SD, Antman EM (2004) Clopidogrel resistance. A new chapter in a fast-moving story. Circulation 109:3064–3067CrossRefPubMed
11.
Zurück zum Zitat Wiviott SD, Braunwald E, McCabe CH et al (2007) Triton-TIMI-38 Investigators. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 357(20):2001–2015CrossRefPubMed Wiviott SD, Braunwald E, McCabe CH et al (2007) Triton-TIMI-38 Investigators. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 357(20):2001–2015CrossRefPubMed
12.
Zurück zum Zitat CURRENT-OASIS-7-Studie (2009) Vorgestellt auf dem Kongress der europäischen Gesellschaft für Kardiologie, Barcelona CURRENT-OASIS-7-Studie (2009) Vorgestellt auf dem Kongress der europäischen Gesellschaft für Kardiologie, Barcelona
13.
Zurück zum Zitat ACTIVE Investigators, Conolly SJ, Pogue J, Hart RG et al (2009) Effect of clopidogrel added to aspirin in patients with atrial fibrillation. N Engl J Med 360(20):2066–2078CrossRef ACTIVE Investigators, Conolly SJ, Pogue J, Hart RG et al (2009) Effect of clopidogrel added to aspirin in patients with atrial fibrillation. N Engl J Med 360(20):2066–2078CrossRef
14.
Zurück zum Zitat Antithrombotic Trialists‘ (ATT) Collaboration (2009) Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomized trials. Lancet 373:1849–1860CrossRef Antithrombotic Trialists‘ (ATT) Collaboration (2009) Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomized trials. Lancet 373:1849–1860CrossRef
15.
Zurück zum Zitat CAPRIE Steering Committee (1996) A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 348:1329–1339CrossRef CAPRIE Steering Committee (1996) A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 348:1329–1339CrossRef
16.
Zurück zum Zitat Serebruany VL, Malinin AI, Ferguson JJ et al (2008) Bleeding risks of combination vs. single antiplatelet therapy: a meta-analysis of 18 randomized trials comparing 129.314 patients. Fundam Clin Pharmacol 22:315–321CrossRefPubMed Serebruany VL, Malinin AI, Ferguson JJ et al (2008) Bleeding risks of combination vs. single antiplatelet therapy: a meta-analysis of 18 randomized trials comparing 129.314 patients. Fundam Clin Pharmacol 22:315–321CrossRefPubMed
17.
Zurück zum Zitat Connolly SJ, Ezekowitz MD, Yusuf S et al (2009) Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 361:1139–1151CrossRefPubMed Connolly SJ, Ezekowitz MD, Yusuf S et al (2009) Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 361:1139–1151CrossRefPubMed
18.
Zurück zum Zitat Hart RG, Benavente O, McBride R, Pearce LA (1999) Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: a meta-analysis. Ann Intern Med 131:492–501PubMed Hart RG, Benavente O, McBride R, Pearce LA (1999) Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: a meta-analysis. Ann Intern Med 131:492–501PubMed
19.
Zurück zum Zitat The Active Investigators. Writing Group (2009) Effect of clopidogrel added to aspirin in patients with atrial fibrillation. N Engl J Med 360:2066–2078CrossRef The Active Investigators. Writing Group (2009) Effect of clopidogrel added to aspirin in patients with atrial fibrillation. N Engl J Med 360:2066–2078CrossRef
20.
Zurück zum Zitat Yeomans N, Lanas A, Labenz J et al (2008) Efficacy of esomeprazole (20 mg once daily) for reducing the risk of gastroduodenal ulcers associated with continuous use of low-dose aspirin. Am J Gastroenterol 103:1–9CrossRef Yeomans N, Lanas A, Labenz J et al (2008) Efficacy of esomeprazole (20 mg once daily) for reducing the risk of gastroduodenal ulcers associated with continuous use of low-dose aspirin. Am J Gastroenterol 103:1–9CrossRef
21.
Zurück zum Zitat Scheiman JM, Rendsburg CJ van, Uebel P et al (2009) Prevention of low-dose acetylsalicyl acid-associated gastric/duodenal ulcers with esomeprazole 20 mg and 40 mg once daily in patients at increased risk of ulcer development: a randomized controlled trial (OBERON). Gastroenterology 136(Suppl):412 Scheiman JM, Rendsburg CJ van, Uebel P et al (2009) Prevention of low-dose acetylsalicyl acid-associated gastric/duodenal ulcers with esomeprazole 20 mg and 40 mg once daily in patients at increased risk of ulcer development: a randomized controlled trial (OBERON). Gastroenterology 136(Suppl):412
22.
Zurück zum Zitat Ibanez L, Vidal X, Vendrell L et al (2006) Spanish-Italian Collaborative Group for the Epidemiology of Gastrointestinal Bleeding. Upper gastrointestinal bleeding associated with antiplatelet drugs. Aliment Pharmacol Ther 23(2):235–242CrossRefPubMed Ibanez L, Vidal X, Vendrell L et al (2006) Spanish-Italian Collaborative Group for the Epidemiology of Gastrointestinal Bleeding. Upper gastrointestinal bleeding associated with antiplatelet drugs. Aliment Pharmacol Ther 23(2):235–242CrossRefPubMed
23.
Zurück zum Zitat Lin K-Y, Hernandez-Diaz S, Rodriguez LAG (2010) Effect of anti-secretory medicines and nitrates on the risk of ulcer bleeding among users of clopidogrel, low-dose acetylsalicyl acid, corticosteroids, non-steroidal anti-inflammatory drugs and oral anticoagulants. DDW #665 Lin K-Y, Hernandez-Diaz S, Rodriguez LAG (2010) Effect of anti-secretory medicines and nitrates on the risk of ulcer bleeding among users of clopidogrel, low-dose acetylsalicyl acid, corticosteroids, non-steroidal anti-inflammatory drugs and oral anticoagulants. DDW #665
24.
Zurück zum Zitat Cuschieri JR, Drawz P, Falck-Ytter Y, Wong RC (2010) Risk factors for acute GI bleeding following myocardial infarction in patients who are prescribed clopidogrel. DDW #108 Cuschieri JR, Drawz P, Falck-Ytter Y, Wong RC (2010) Risk factors for acute GI bleeding following myocardial infarction in patients who are prescribed clopidogrel. DDW #108
25.
Zurück zum Zitat Kazui M, Nishiya Y, Ishizuka T et al (2010) Identification of the human cytochrome P450 enzymes involved in the two oxidative steps in the bioactivation of clopidogrel to its pharmacologically active metabolite. Drug Metab Dispos 38(1):92–99CrossRefPubMed Kazui M, Nishiya Y, Ishizuka T et al (2010) Identification of the human cytochrome P450 enzymes involved in the two oxidative steps in the bioactivation of clopidogrel to its pharmacologically active metabolite. Drug Metab Dispos 38(1):92–99CrossRefPubMed
26.
Zurück zum Zitat Sibbing D, Koch W, Gebhard D et al (2010) Cytochrome 2C19*17 allelic variant, platelet aggregation, bleeding events and stent thrombosis in clopidogrel-treated patients with coronary stent placement. Circulation 121(4):512–518CrossRefPubMed Sibbing D, Koch W, Gebhard D et al (2010) Cytochrome 2C19*17 allelic variant, platelet aggregation, bleeding events and stent thrombosis in clopidogrel-treated patients with coronary stent placement. Circulation 121(4):512–518CrossRefPubMed
27.
Zurück zum Zitat Li X-Q, Andersson TB, Ahlström A, Weidolf L (2004) Comparison of inhibitory effects of the proton pump inhibiting drugs omeprazole, esomeprazole, lansoprazole, pantoprazole and rabeprazole on human cytochrome P450. Drug Metab Dispos 32:821–827CrossRefPubMed Li X-Q, Andersson TB, Ahlström A, Weidolf L (2004) Comparison of inhibitory effects of the proton pump inhibiting drugs omeprazole, esomeprazole, lansoprazole, pantoprazole and rabeprazole on human cytochrome P450. Drug Metab Dispos 32:821–827CrossRefPubMed
28.
Zurück zum Zitat Ko JW, Sukhova N, Thacker D et al (1997) Evaluation of omeprazole and lansoprazole as inhibitors of cytochrome P450 isoforms. Drug Metab Dispos 25(7):853–862PubMed Ko JW, Sukhova N, Thacker D et al (1997) Evaluation of omeprazole and lansoprazole as inhibitors of cytochrome P450 isoforms. Drug Metab Dispos 25(7):853–862PubMed
29.
Zurück zum Zitat Lefebvre RA, Flouvat B, Karolac-Tamisier S et al (1992) Influence of lansoprazole treatment on diazepam plasma concentrations. Clin Pharmacol Ther 52(5):458–463CrossRefPubMed Lefebvre RA, Flouvat B, Karolac-Tamisier S et al (1992) Influence of lansoprazole treatment on diazepam plasma concentrations. Clin Pharmacol Ther 52(5):458–463CrossRefPubMed
30.
Zurück zum Zitat Gilard M, Arnaud B, Cornily JC et al (2008) Influence of omeprazole on the antiplatelet action of clopidogrel associated with aspirin: the randomized, double-blind OCLA (Omeprazole CLopidogrel Aspirin) study. J Am Coll Cardiol 51:256–260CrossRefPubMed Gilard M, Arnaud B, Cornily JC et al (2008) Influence of omeprazole on the antiplatelet action of clopidogrel associated with aspirin: the randomized, double-blind OCLA (Omeprazole CLopidogrel Aspirin) study. J Am Coll Cardiol 51:256–260CrossRefPubMed
31.
Zurück zum Zitat Cuisset T, Frere C, Quirlici J et al (2009) Comparison of omeprazole and pantoprazole influence on a high 150 mg clopidogrel maintenance dose. The PACA (Proton Pump Inhibitors And clopidogrel Association) prospective randomized study. J Am Coll Cardiol 54(13):1149–1153CrossRefPubMed Cuisset T, Frere C, Quirlici J et al (2009) Comparison of omeprazole and pantoprazole influence on a high 150 mg clopidogrel maintenance dose. The PACA (Proton Pump Inhibitors And clopidogrel Association) prospective randomized study. J Am Coll Cardiol 54(13):1149–1153CrossRefPubMed
32.
Zurück zum Zitat O’Donoghue ML, Braunwald E, Antman EM et al (2009) Pharmacodynamic effect and clinical efficacy of clopidogrel and prasugrel with or without a proton-pump inhibitor: an analysis of two randomised trials. Lancet 374:989–997CrossRef O’Donoghue ML, Braunwald E, Antman EM et al (2009) Pharmacodynamic effect and clinical efficacy of clopidogrel and prasugrel with or without a proton-pump inhibitor: an analysis of two randomised trials. Lancet 374:989–997CrossRef
33.
Zurück zum Zitat Price MJ, Nayak KR, Barker CM et al (2009) Predictors of heightened platelet reactivity despite dual-antiplatelet therapy in patients undergoing percutaneous coronary intervention. Am J Cardiol 103:1339–1343CrossRefPubMed Price MJ, Nayak KR, Barker CM et al (2009) Predictors of heightened platelet reactivity despite dual-antiplatelet therapy in patients undergoing percutaneous coronary intervention. Am J Cardiol 103:1339–1343CrossRefPubMed
34.
Zurück zum Zitat Zuern CS, Geisler T, Lutilsky N et al (2010) Effect of comedication with proton pump inhibitors (PPIs) on post-interventional residual platelet aggregation in patients undergoing coronary stenting treated by dual antiplatelet therapy. Thromb Res 125:e51–e54CrossRefPubMed Zuern CS, Geisler T, Lutilsky N et al (2010) Effect of comedication with proton pump inhibitors (PPIs) on post-interventional residual platelet aggregation in patients undergoing coronary stenting treated by dual antiplatelet therapy. Thromb Res 125:e51–e54CrossRefPubMed
35.
Zurück zum Zitat Sibbing D, Morath T, Stegherr J et al (2009) Impact of proton pump inhibitors on the antiplatelet effects of clopidogrel. Thromb Haemost 101714–101719 Sibbing D, Morath T, Stegherr J et al (2009) Impact of proton pump inhibitors on the antiplatelet effects of clopidogrel. Thromb Haemost 101714–101719
36.
Zurück zum Zitat Siller-Matula JM, Spiel AO, Lang IM et al (2009) Effects of pantoprazole and esomeprazole on platelet inhibition by clopidogrel. Am Heart J 157:148.e1–e5CrossRefPubMed Siller-Matula JM, Spiel AO, Lang IM et al (2009) Effects of pantoprazole and esomeprazole on platelet inhibition by clopidogrel. Am Heart J 157:148.e1–e5CrossRefPubMed
37.
Zurück zum Zitat FDA. Information for Healthcare Professionals: Update to the labeling of Clopidogrel Bisulfate (marketed as Plavix) to alert healthcare professionals about a drug interaction with omeprazole (marketed as Prilosec and Prilosec OTC) (17.11.2009) http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm190787.htm FDA. Information for Healthcare Professionals: Update to the labeling of Clopidogrel Bisulfate (marketed as Plavix) to alert healthcare professionals about a drug interaction with omeprazole (marketed as Prilosec and Prilosec OTC) (17.11.2009) http://​www.​fda.​gov/​Drugs/​DrugSafety/​PostmarketDrugSa​fetyInformationf​orPatientsandPro​viders/​DrugSafetyInform​ationforHeathcar​eProfessionals/​ucm190787.​htm
38.
Zurück zum Zitat Beitelshees AL, McLeod HL (2006) Clopidogrel pharmacogenetics: Promising steps towards patient care? Arterioscler Thromb Vasc Biol 26:1681–1683CrossRefPubMed Beitelshees AL, McLeod HL (2006) Clopidogrel pharmacogenetics: Promising steps towards patient care? Arterioscler Thromb Vasc Biol 26:1681–1683CrossRefPubMed
39.
Zurück zum Zitat Ho PM, Maddox TM, Wang L et al (2009) Risk of adverse outcomes associated with concomitant use of clopidogrel and proton pump inhibitors following acute coronary syndrom. JAMA 301(9):937–944CrossRefPubMed Ho PM, Maddox TM, Wang L et al (2009) Risk of adverse outcomes associated with concomitant use of clopidogrel and proton pump inhibitors following acute coronary syndrom. JAMA 301(9):937–944CrossRefPubMed
40.
Zurück zum Zitat Van Boxel OS, Oijen MG van, Hagenaars MP et al (2010) New clopidogrel users on PPIs are at an increased risk of cardiovascular and gastrointestinal complications – results of a large Dutch cohort study. DDW #107 Van Boxel OS, Oijen MG van, Hagenaars MP et al (2010) New clopidogrel users on PPIs are at an increased risk of cardiovascular and gastrointestinal complications – results of a large Dutch cohort study. DDW #107
41.
Zurück zum Zitat Juurlink DN, Gomes T, Ko DT et al (2009) A population-based study of the drug interaction between proton pump inhibitors and clopidogrel. CMAJ 180(7):713–718PubMed Juurlink DN, Gomes T, Ko DT et al (2009) A population-based study of the drug interaction between proton pump inhibitors and clopidogrel. CMAJ 180(7):713–718PubMed
42.
Zurück zum Zitat Stockl KM, Zakharyan A, Harada AS et al (2010) Risk of rehospitalization for patients using clopidogrel with a proton pump inhibitor. Arch Intern Med 170(8):704–710CrossRefPubMed Stockl KM, Zakharyan A, Harada AS et al (2010) Risk of rehospitalization for patients using clopidogrel with a proton pump inhibitor. Arch Intern Med 170(8):704–710CrossRefPubMed
43.
Zurück zum Zitat Gaglia MA, Torguson R, Hanna N et al (2010) Relation of proton pump inhibitor use after percutaneous intervention with drug-diluting stents to outcomes. Am J Cardiol 105(6):833–838CrossRefPubMed Gaglia MA, Torguson R, Hanna N et al (2010) Relation of proton pump inhibitor use after percutaneous intervention with drug-diluting stents to outcomes. Am J Cardiol 105(6):833–838CrossRefPubMed
44.
Zurück zum Zitat Ray WA, Murray KT, Griffin MR et al (2010) Outcomes with concurrent use of clopidogrel and proton-pump inhibitors: a cohort study. Ann Intern Med 152(6):337–345PubMed Ray WA, Murray KT, Griffin MR et al (2010) Outcomes with concurrent use of clopidogrel and proton-pump inhibitors: a cohort study. Ann Intern Med 152(6):337–345PubMed
45.
Zurück zum Zitat Kwok CS, Loke YK (2010) Meta-analysis: the effects of proton pump inhibitors on cardiovascular events and mortalitiy in patients receiving clopidogrel. Aliment Pharmacol Ther 31:810–823PubMed Kwok CS, Loke YK (2010) Meta-analysis: the effects of proton pump inhibitors on cardiovascular events and mortalitiy in patients receiving clopidogrel. Aliment Pharmacol Ther 31:810–823PubMed
46.
Zurück zum Zitat Ngamruengphong S, Leontiadis GI, Crowell MD et al (2010) Risk of adverse cardiovascular events with concomitant use of clopidogrel and proton pumpinhibitors (PPI): systematic review and meta-analysis of observational studies. DDW #T1078 Ngamruengphong S, Leontiadis GI, Crowell MD et al (2010) Risk of adverse cardiovascular events with concomitant use of clopidogrel and proton pumpinhibitors (PPI): systematic review and meta-analysis of observational studies. DDW #T1078
47.
Zurück zum Zitat Gerson LB, McMahon D, Olkin I et al (2010) Meta-analysis of interaction between clopidogrel and proton pump inhibitor therapy. DDW #W1108 Gerson LB, McMahon D, Olkin I et al (2010) Meta-analysis of interaction between clopidogrel and proton pump inhibitor therapy. DDW #W1108
48.
Zurück zum Zitat Dunn SP, Macaulay TE, Brennan DM et al (2008) Abstract 3999: Baseline proton pump inhibitor use is associated with increased cardiovascular events with and without the use of clopidogrel in the CREDO trial. Circulation 118:S815 Dunn SP, Macaulay TE, Brennan DM et al (2008) Abstract 3999: Baseline proton pump inhibitor use is associated with increased cardiovascular events with and without the use of clopidogrel in the CREDO trial. Circulation 118:S815
49.
Zurück zum Zitat Simon T, Verstuyft C, Mary-Krause M et al (2009) Genetic determinants of response to clopidogrel and cardiovascular events. N Engl J Med 360:363–375CrossRefPubMed Simon T, Verstuyft C, Mary-Krause M et al (2009) Genetic determinants of response to clopidogrel and cardiovascular events. N Engl J Med 360:363–375CrossRefPubMed
50.
Zurück zum Zitat Zairis M, Patsourakos N, Makrygiannis S et al (2008) The impact of oral proton pump inhibitors on the effectiveness of combined aspirin and clopidogrel drug therapy during the first year after elective coronary stenting. Eur Heart J 29(Suppl):134 Zairis M, Patsourakos N, Makrygiannis S et al (2008) The impact of oral proton pump inhibitors on the effectiveness of combined aspirin and clopidogrel drug therapy during the first year after elective coronary stenting. Eur Heart J 29(Suppl):134
51.
Zurück zum Zitat Depta JP, Bhatt DL (2010) Omeprazole and clopidogrel: Should clinicians be worried? Cleve Clin J Med 77(2):113–116CrossRefPubMed Depta JP, Bhatt DL (2010) Omeprazole and clopidogrel: Should clinicians be worried? Cleve Clin J Med 77(2):113–116CrossRefPubMed
52.
Zurück zum Zitat Targownik LE, Metge CJ, Leung S, Chateau DG (2008) The relative efficacies of gastroprotective strategies in chronic users of nonsteroidal anti-inflammatory drugs. Gastroenterology 134(4):937–944CrossRefPubMed Targownik LE, Metge CJ, Leung S, Chateau DG (2008) The relative efficacies of gastroprotective strategies in chronic users of nonsteroidal anti-inflammatory drugs. Gastroenterology 134(4):937–944CrossRefPubMed
53.
Zurück zum Zitat Kenngott S, Olze R, Kollmer M et al (2010) Clopidogrel and proton pump inhibitor (PPI) interaction: Separate intake and a non-omeprazole PPI the solution? Eur J Med Res 15:1–5 Kenngott S, Olze R, Kollmer M et al (2010) Clopidogrel and proton pump inhibitor (PPI) interaction: Separate intake and a non-omeprazole PPI the solution? Eur J Med Res 15:1–5
54.
Zurück zum Zitat Neubauer H, Engelhardt A, Krüger JC et al (2010) Pantoprazole does not influence the antiplatelet effect of clopidogrel – a whole blood aggregometry study following coronary stenting. J Cardiovasc Pharmacol [Epub ahead of print] Neubauer H, Engelhardt A, Krüger JC et al (2010) Pantoprazole does not influence the antiplatelet effect of clopidogrel – a whole blood aggregometry study following coronary stenting. J Cardiovasc Pharmacol [Epub ahead of print]
55.
Zurück zum Zitat Hokimoto S, Ogawa H (2010) Is it safe to use a proton pump inhibitor with clopidogrel? A comparison of clopidogrel with or without rabeprazole in Japan. DDW #T1145 Hokimoto S, Ogawa H (2010) Is it safe to use a proton pump inhibitor with clopidogrel? A comparison of clopidogrel with or without rabeprazole in Japan. DDW #T1145
56.
Zurück zum Zitat Furuta T, Sugimoto M, Kodaira C et al (2010) Effect of different proton pump inhibitors on the antiplatelet activity of clopidogrel in relation to CYP2C19 genotype status. DDW #T1013 Furuta T, Sugimoto M, Kodaira C et al (2010) Effect of different proton pump inhibitors on the antiplatelet activity of clopidogrel in relation to CYP2C19 genotype status. DDW #T1013
Metadaten
Titel
Gleichzeitige Anwendung von Thrombozytenaggregationshemmern und Protonenpumpeninhibitoren (PPIs)
Positionspapier der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Kardiologie (DGK)
verfasst von
Prof. Dr. W. Fischbach
H. Darius
M. Gross
H. Koop
I. Kruck
K.U. Petersen
Publikationsdatum
01.10.2010
Verlag
Springer-Verlag
Erschienen in
Die Kardiologie / Ausgabe 5/2010
Print ISSN: 2731-7129
Elektronische ISSN: 2731-7137
DOI
https://doi.org/10.1007/s12181-010-0298-7

Weitere Artikel der Ausgabe 5/2010

Der Kardiologe 5/2010 Zur Ausgabe

CME Weiterbildung · Zertifizierte Fortbildung

Echokardiographie als Wegweiser in der Peri-Reanimation

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

NSCLC: Progressionsfreies Überleben unter Osimertinib fast versiebenfacht

06.06.2024 ASCO 2024 Kongressbericht

Erste Ergebnisse der Phase-III-Studie LAURA etablieren Osimertinib als neuen Therapiestandard für Menschen mit nicht-resezierbarem, EGFR-mutiertem, nicht-kleinzelligem Lungenkarzinom im Stadium III, die nach definitiver Radiochemotherapie progressionsfrei sind. Auf der ASCO-Tagung wurden diese beeindruckenden Ergebnisse besprochen.

Hodgkin Lymphom: BrECADD-Regime übertrifft die Erwartungen

05.06.2024 ASCO 2024 Kongressbericht

Das Kombinationsregime BrECADD mit Brentuximab vedotin ermöglichte in der Studie HD21 beim fortgeschrittenen klassischen Hodgkin-Lymphom eine unerwartet hohe progressionsfreie Überlebensrate von 94,3% nach vier Jahren. Gleichzeitig war das Regime besser tolerabel als der bisherige Standard eBEACOPP.

Antikörper-Drug-Konjugat verdoppelt PFS bei Multiplem Myelom

05.06.2024 ASCO 2024 Nachrichten

Zwei Phase-3-Studien deuten auf erhebliche Vorteile des Antikörper-Wirkstoff-Konjugats Belantamab-Mafodotin bei vorbehandelten Personen mit Multiplem Myelom: Im Vergleich mit einer Standard-Tripeltherapie wurde das progressionsfreie Überleben teilweise mehr als verdoppelt.

Neuer TKI gegen CML: Höhere Wirksamkeit, seltener Nebenwirkungen

05.06.2024 Chronische myeloische Leukämie Nachrichten

Der Tyrosinkinasehemmer (TKI) Asciminib ist älteren Vertretern dieser Gruppe bei CML offenbar überlegen: Personen mit frisch diagnostizierter CML entwickelten damit in einer Phase-3-Studie häufiger eine gute molekulare Response, aber seltener ernste Nebenwirkungen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.