Lots of interesting abstracts and cases were submitted for TCTAP 2021 Virtual. Below are accepted ones after thoroughly reviewed by our official reviewers. Don’t miss the opportunity to explore your knowledge and interact with authors as well as virtual participants by sharing your opinion!
TCTAP A-033
Presenter
Shaban Mohammed
Authors
Shaban Mohammed1, Abdulrahaman Arabi2, Nawel Bensmail2, Ahmed Moursi3, Mohamed Sharabash2, Ayman El-Menyar1, Rania Abdel-Latif4, Salah Arafa5, Ihsan Rafie5, Awad Alqahtani5, Moza Al Hail1, Nidal Asaad2, Jassim Al Suwaidi5
Affiliation
Hamad Medical Corporation, Qatar1, HMC Heart Hospital, Qatar2, Pharmacy Department, Hamad Medical Corporation, Qatar3, Minia University, Egypt4, Hamad Medical Corporation (HMC), Doha, Qatar5
View Study Report
TCTAP A-033
Pharmacology/Pharmacotherapy
The Impact of Concomitant Use of Proton Pump Inhibitors and Clopidogrel on Patient Mortality and Outcome Post Angioplasty
Shaban Mohammed1, Abdulrahaman Arabi2, Nawel Bensmail2, Ahmed Moursi3, Mohamed Sharabash2, Ayman El-Menyar1, Rania Abdel-Latif4, Salah Arafa5, Ihsan Rafie5, Awad Alqahtani5, Moza Al Hail1, Nidal Asaad2, Jassim Al Suwaidi5
Hamad Medical Corporation, Qatar1, HMC Heart Hospital, Qatar2, Pharmacy Department, Hamad Medical Corporation, Qatar3, Minia University, Egypt4, Hamad Medical Corporation (HMC), Doha, Qatar5
Background
Numerous studies have suggested the routinely prescribed proton-pump inhibitors (PPIs) for patients receiving dual antiplatelet therapy post angioplasty, would blunt platelet inhibitory effects of clopidogrel. However, evidence on the clinical consequences of concomitant use of PPI and clopidogrel post angioplasty showing a large diversity. This study was conducted to investigate the impact of PPI administration on clinical outcome and mortality in patients treated with clopidogrel after percutaneous coronary intervention (PCI).
Methods
During this retrospective cohort study, all patients who had PCI were identified during the period of October 2012 to March 2013. All involved participants were represented in the only tertiary heart hospital in Qatar for PCI. An eighteen-month follow-up period was assigned to report clinical outcome and tract clopidogrel and PPI use.
Results
Of 550 patients who underwent PCI and taking clopidogrel, 375 (68%) were discharged on PPI. Current demographic data including age, sex/gender, race, and ethnicity showed a non-significant difference between patients who received PPI (PPI group) and those who were not received PPI (non-PPI group). Percentage of diabetic and hypertensive patients were comparable in both PPI and non-PPI groups (35.2, 39.2 vs. 33.7, 45.1%; p=0.73 and p=0.19, respectively). In analyses of clinical outcomes, regardless of the type of PPI, patients taking clopidogrel plus PPI showed a non-significant difference in the rate of restenosis (2.9 vs. 4.0%; p=0.51) and stent thrombosis (0.5 vs. 0.6%; p=0.95) compared to non-PPI patients’ group. Hospital re-admission rate for recurrent cardiovascular events was in significance in PPI group compared with non-PPI group (26.1 vs. 26.3%, p=0.97). PPI patients group showed a non-significant in-hospital mortality rate (1.9%) and one-year mortality rate (3.5%) compared with non-PPI patients’ group (1.7; p=0.9) and (1.7; p=0.25) respectively. In a multivariate analysis, the use of PPI was not associated with one-year mortality in patients treated with clopidogrel after PCI (odds ratio, 1.25; 95% confidence interval (CI)), 0.327-4.846; p=0.73). Additionally, the adjusted hazard ratio (HR) of PPI-use for mortality was 1.25 (95% confidence interval (CI): 0.69-3.3, p= 0.303).
Conclusion
Among patients on clopidogrel after PCI, the use of PPI was not associated with long-term mortality. Clinical outcomes were also not appreciably different according to PPI use. further randomized clinical trials are needed to evaluate the safety of concomitant PPI and clopidogrel use in patients with CAD.