Arestrospectiv Analysis: Effects Of Proton Pump Inhitors On In-stent Restenosis In Patients Receiving Clopidogrel

Objective:Recent studies have suggested that the use of proton pump inhibitor(PPI) may be associated with attenuation of clopidogrel's benefits for patients post percutaneous coronary intervention(PCI), but whether it has relationship with in-stent restenosis(ISR) is unknown. The objective of our study is to determine whether post-PCI patients discharged on concomitant clopidogrel-PPI therapy would have higher ratio of ISR compared with those discharged on clopidogrel only.Methods:We reviewed the medical records of total 439 patients in Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University from January 4,2006 to March 3,2010 discharged on clopidogrel who underwent PCI and had the secend coronary angiography. The patients were divided to two groups, post-PCI patients discharged on clopidogrel only(n=250) and post-PCI patients discharged on clopidogrel added with PPI(n=189). The in-stent restenosis (ISR) ratio of the patients in these two groups were observed.Result:During a mean follow-up period of 13±5.9 months, the post-PCI patients discharged on concomitant clopidogrel-PPI therapy had higher risk of ISR than those dicharged on clopidogrel only(19.6% vs 8%, P＜0.001).Conclusion:Concomitant use of clopidogrel and PPI after hospital discharge would increased the risk of ISR for post-PCI patients, suggesting that use of PPI may be associated with attenuation of benefits of clopidogrel for post-PCI patients.