The Clinical Study Of Influences Of Rabeprazole On Antiplatelet Effects Of Clopidogrel

Objective:The clinical study applied in patients with coronary heart disease-unstable angina to explore whether Rabeprazole can reduce the antiplatelet effect of clopidogrel, and the influence on the effect of dual antiplatelet when Rabeprazole medicated at different time.Methods:300patients presented in our hospital with coronary heart disease-unstable angina, were equally randomized into group A, B, C. Patients in Group A were treated with dual antiplatelet therapy, namely Aspirin (Bayer, Germany) and Clopidogrel Bisulfate Tablets (Salubris, China); Patients in Group B were treated with Rabeprazole (Rundu Pharmarcy, China) based on the dual antiplatelet therapy; Patients in Group C were given dual antiplatelet therapy in the morning and Rabeprazole20mg/d in the evening. All patients were followed-up for3months for major adverse cardiovascular events, including myocardial infarction, stroke, death, target lesion revascularization, etc.Results:(1) The difference between the baseline characteristics of each group were not significant statistically (P>0.05),(2) The platelet aggregation rate were significantly decreased on the seventh day in each group (P<0.05).(3)The anti-platelet aggregation effects were not statistically different on the seventh day in each group (P>0.05),(4) All patients were followed up for3months.8cases in Group A,1case in Group B and2cases in Group C suffered the digestive tract hemorrhage and the difference was statistically significant (P<0.05);2cases in Group A suffered nonfatal myocardial infarction.1case in Group B suffered cardiac death, another nonfatal myocardial infarction.2cases in Group C were re-hospitalized for the myocardial ischemia and1case occurred nonfatal myocardial infarction. The difference has no statistically significance as well(P>0.05).Conclusion:(1) compared with Rabeprazole, the antiplatelet effect of clopidogrel has no apparent influence, the combination of both did not significantly increase the rate of platelet aggregation.(2) the impacts from the combination of Rabeprazole dual antiplatelet therapy were not different significantly.(3) Rabeprazole can reduce the risk of alimentary tract hemorrhage through dual antiplatelet therapy to a certain extent, but did not increase the incidence of major adverse cardiac events within three months significantly.(4) patients with unstable angina might benefit from, clopidogrel combined with Rabeprazole which was given at different time.