UNASSIGNED: Many pharmacokinetic (PK) and pharmacodynamic (PD) studies have confirmed the interaction, especially between PPIs and clopidogrel, but with uncertain consequences on clinical outcomes. Therefore, we aimed to summarize the evidence for the widespread combined use of oral antiplatelet drugs and PPIs, to outline the current evidence supporting or opposing drug-drug interaction, and to discuss the clinical implications of such interactions.
UNASSIGNED: A large body of evidence describes the PK/PD interaction of antiplatelet drugs with PPIs and its potential role in increasing clinical cardiovascular adverse events, but no solid clinical data have confirmed these effects. In the light of the published studies, there seems to be no restriction on the choice of PPI with aspirin, prasugrel, and/or ticagrelor. The choice of a PPI with no (or minimal) interference with the hepatic cytochrome P450 2C19 is preferred in patients receiving clopidogrel.
■许多药代动力学(PK)和药效学(PD)研究已经证实了相互作用,尤其是在PPI和氯吡格雷之间,但对临床结果的影响不确定。因此,我们旨在总结口服抗血小板药物和PPI广泛联合使用的证据,概述当前支持或反对药物相互作用的证据,并讨论这种相互作用的临床意义。
■大量证据描述了抗血小板药物与PPI的PK/PD相互作用及其在增加临床心血管不良事件中的潜在作用,但没有可靠的临床数据证实这些影响。根据已发表的研究,阿司匹林对PPI的选择似乎没有限制,普拉格雷和/或替格瑞洛。在接受氯吡格雷的患者中,首选不(或最小)干扰肝细胞色素P4502C19的PPI。