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All Journal JURNAL GIZI INDONESIA Jurnal Kedokteran Diponegoro Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Molecular and Cellular Biomedical Sciences (MCBS) Jurnal Profesi Medika: Jurnal Kedokteran dan Kesehatan AcTion: Aceh Nutrition Journal Jurnal Aplikasi Teknologi Pangan Journal of Tropical Pharmacy and Chemistry
Endang Mahati
Departemen Farmakologi Dan Terapi, Fakultas Kedokteran, Universitas Diponegoro, Semarang
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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The influence of proton pump inhibitors on the effect of clopidogrel on the risk of recurrent ischemic stroke Endang Mahati; Jarir Atthobari; . Ngatidjan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 47, No 2 (2015)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (326.004 KB) | DOI: 10.19106/JMedSci004702201503

Abstract

Patients surviving with a stroke have an increased risk for recurrent stroke. Clopidogrel iswidely used to prevent recurrent stroke. However, clopidogrel may cause gastrointestinalbleeding (GIB). Therefore, proton pump inhibitors (PPIs) is recommended to reduce theside effect of clopidogrel. Unfortunately, these both drugs are metabolized in the liverby the same enzyme i.e. cytochrome P4502C19 (CYP219) that may reduce the effectof clopidogrel. The aim of this study was to evaluate the influence of PPIs on the effectof clopidogrel in the prevention of recurrent stroke. It was a hospital-based case controlstudy conducted in Bethesda Private Hospital, Yogyakarta involving 392 patients withrecurrent stroke as cases and 784 patients with first-ever stroke as controls. The exposureof PPIs during clopidogrel therapy on both cases and controls groups were recordedfrom prescription records for at least six months before index date. The duration of PPIsexposure were categorized as current expoure (less than two months before the indexdate) and recent exposure (2-6 months before the index date). The result showed therewas no influence of PPIs exposure on the effect of clopidogrel on the risk of recurrentischemic stroke (OR: 1.00; 95% CI: 0.56-1.79). Moreover, the current use of PPIs andclopidogrel could decrease the risk of recurrent ischemic stroke (OR: 0.04; 95% CI:0.01-0.41). In conclusion, there is no association between PPI exposure and the risk ofrecurrent stroke in patients receiving clopidogrel.
Co-Authors . Ngatidjan Abdul Khairul Rizki Purba Adriyan Pramono Anjani, Gemala Diana Nur Afifah, Diana Nur Dodik Pramukarso Dwi Pudjonarko Dzaki Edmonda Setyawan Elfrida Sianturi Etika R. Noer Etika Ratna Noer Feriyandi Nauli Fina Alvia Rahma Hery Djagat Purnomo Indwiani Astuti Jarir At Thobari Kartika, Yolanda Dyah Martha Irene Kartasurya Mohammad Zen Rahfiludin Nani Maharani Nurhasanah Nurhasanah Nyoman Kertia Qurrota A'yun Febrina Triwindiyanti R.A. Kisdjamiatun RMD Retnaningsih Retnaningsih Ryan Halleyantoro Stephani Nesya Renamastika Tiffany Nisa Arviyani Udin Bahrudin Viqi Sajidah