Clinical Outcomes Following Coronary Stenting in Japanese Patients Treated With and Without Proton Pump Inhibitor

Tadasuke Chitose; Seiji Hokimoto; Shuichi Oshima; Koichi Nakao; Kazuteru Fujimoto; Yuji Miyao; Hideki Shimomura; Ryusuke Tsunoda; Hideki Maruyama; Toyoki Hirose; Koichiro Yamamoto; Michio Mizobe; Koichi Kaikita; Sunao Nakamura; Hisao Ogawa; on behalf of Kumamoto Intervention Conference Study (KICS) Investigators

doi:10.1253/circj.CJ-11-0699

Cardiovascular Intervention

Clinical Outcomes Following Coronary Stenting in Japanese Patients Treated With and Without Proton Pump Inhibitor

Tadasuke Chitose, Seiji Hokimoto, Shuichi Oshima, Koichi Nakao, Kazuteru Fujimoto, Yuji Miyao, Hideki Shimomura, Ryusuke Tsunoda, Hideki Maruyama, Toyoki Hirose, Koichiro Yamamoto, Michio Mizobe, Koichi Kaikita, Sunao Nakamura, Hisao Ogawa, on behalf of Kumamoto Intervention Conference Study (KICS) Investigators

Author information

Tadasuke Chitose
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
Seiji Hokimoto
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
Shuichi Oshima
Division of Cardiology, Kumamoto Central Hospital
Koichi Nakao
Cardiovascular Center, Kumamoto Saiseikai Hospital
Kazuteru Fujimoto
National Hospital Organization Kumamoto Medical Center
Yuji Miyao
National Hospital Organization Kumamoto Medical Center
Hideki Shimomura
Division of Cardiology, Fukuoka Tokushukai Hospital
Ryusuke Tsunoda
Kumamoto Red Cross Hospital
Hideki Maruyama
Division of Cardiology, Minamata City Hospital and Medical Center
Toyoki Hirose
Division of Cardiology, Minamata City Hospital and Medical Center
Koichiro Yamamoto
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
Michio Mizobe
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
Koichi Kaikita
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
Sunao Nakamura
Cardiovascular Center, New Tokyo Hospital
Hisao Ogawa
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
on behalf of Kumamoto Intervention Conference Study (KICS) Investigators

Keywords: Antiplatelet therapy, Coronary heart disease, Pharmacology

JOURNAL FREE ACCESS

2012 Volume 76 Issue 1 Pages 71-78

DOI https://doi.org/10.1253/circj.CJ-11-0699

View "Advance Publication" version (December 1, 2011).

Details

Abstract

Background: The aim of this study was to examine the effect of proton-pump inhibitor (PPI) on clinical outcomes in Japanese patients who undergo coronary stent implantation. Methods and Results: A total of 1,270 patients (males 915, 69 years) were enrolled and dual antiplatelet therapy of aspirin and a thienopyridine derivative was prescribed (clopidogrel 630, ticlopidine 640). Patients were divided into 2 groups treated with or without PPI. PPI was administered in 331 cases (26%), and non-PPI in 939 (74%). There were no significant differences in cardiovascular death (PPI vs. non-PPI: 5 vs. 11 cases), nonfatal myocardial infarction (3 vs. 5), and stroke (3 vs. 16) between PPI and non-PPI groups, but the ratio of gastrointestinal events had a higher tendency in non-PPI group compared with PPI group (1 vs. 17, P=0.08). In subgroup analysis of patients taking clopidogrel, or patients with acute coronary syndrome, there was no significant difference in the ratio of cardiovascular events (7 vs. 16, 6 vs. 17, NS). The non-PPI group had a tendency of an increased risk of gastrointestinal events compared with the PPI group (0 vs. 9, P=0.06; 1 vs. 7, P=0.14). Conclusions: In contrast to the negative drug interaction of PPI reported elsewhere, in the present study the intake of PPI was not associated with an increased risk for adverse clinical outcomes in patients treated with stents. (Circ J 2012; 76: 71-78)

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