Abstract:
BACKGROUND:Proton pump inhibitors (PPIs) are usually prescribed to patients undergoing dual antiplatelet therapy to decrease the risk of gastrointestinal bleeding. Recent studies have raised concerns that PPIs could reduce clopidogrel's efficacy by competitive inhibition of cytochrome P450 2C19 isoenzyme. All PPIs are metabolized by cytochrome P450 2C19, although to varying degrees, and according to in-vitro studies, pantoprazole is the weakest inhibitor of this isoenzyme. We hypothesized that this drug interaction might not be a class effect. METHODS:One month after an acute myocardial infarction 34 consecutive patients undergoing dual antiplatelet therapy were prospectively analyzed. Platelet function was measured (VerifyNow system), in each patient, in three consecutive clinical scenarios: (i) first, after a 1-month washout period, without any PPI, (ii) after a 4-week period taking omeprazole 40 mg, and (iii) after another 1-month washout period, followed by 4-weeks taking pantoprazole 40 mg. In this crossover trial, patients were first randomized to receive either omeprazole or pantoprazole. RESULTS:We observed a significant reduction in clopidogrel's effect when patients were initiated with omeprazole; the mean P2Y12 reaction units (PRU) increased from 202±52 to 235±58 with omeprazole (P<0.001). With pantoprazole, clopidogrel efficacy was preserved (PRU 215±54, P=0.16). Without any PPI, 26% of patients were 'nonresponders' to clopidogrel (PRU >240) but when patients started omeprazole, this proportion increased to 45 versus 23% with pantoprazole. CONCLUSION:In this randomized crossover study analyzing patients after acute myocardial infarction, omeprazole coadministration showed a significant pharmacodynamic interaction with clopidogrel, whereas pantoprazole did not. These data suggest that the clopidogrel-PPIs drug interaction may not be a class effect.
journal_name
Eur J Gastroenterol Hepatoljournal_title
European journal of gastroenterology & hepatologyauthors
Fontes-Carvalho R,Albuquerque A,Araújo C,Pimentel-Nunes P,Ribeiro VGdoi
10.1097/MEG.0b013e3283460110subject
Has Abstractpub_date
2011-05-01 00:00:00pages
396-404issue
5eissn
0954-691Xissn
1473-5687journal_volume
23pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Liver steatosis (LS) and chronic infection with hepatitis B virus (HBV) are two common causes of chronic liver disease in Iran. LS is also a common histopathological feature of chronic hepatitis B (CHB). Association of chronic HBV infection and LS has not been extensively studied. AIM:We investigated the pr...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/MEG.0b013e328326792e
更新日期:2009-05-01 00:00:00
abstract::We report a case of oesophageal carcinoma with humoral hypercalcaemia of malignancy and leucocytosis in a 66-year-old man. We also demonstrate parathyroid hormone-related protein, by immunohistology. After admission, calcitonin was administered for the hypercalcaemia but the patient died of pneumonia on the 17th day o...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Hereditary angioneurotic oedema (HAE) is a rare cause of ascites. As acute abdominal attacks of the disease can mimic surgical emergencies, prompt and accurate diagnosis is essential. This study was undertaken to evaluate the usefulness of serial abdominal ultrasound (US) examinations. PATIENTS AND METHODS:...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/00042737-200110000-00016
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVES:Clostridium difficile infection (CDI) is an acute gastrointestinal infection caused by anaerobic, toxin-producing bacteria. During the course of CDI, there is a general inflammatory state. In order to gain a deeper understanding of the role of fatty acids (FAs) in the pathogenesis of acute infection we analy...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/MEG.0000000000001600
更新日期:2020-03-01 00:00:00
abstract:INTRODUCTION:There is conflicting evidence on the benefit of early transjugular intrahepatic portosystemic shunt (TIPSS) on the survival of patients with acute variceal bleeding (AVB). AIM:To assess the effect of early TIPSS on patient prognosis. MATERIALS AND METHODS:We carried out a meta-analysis of trials evaluati...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MEG.0000000000000403
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Studying factors associated with positive gastroscopies in dyspeptic patients can help limit and rationalize waiting lists for endoscopies. Dyspepsia guidelines have a controversial role because their main purpose is to provide specifications on efficient global management of primary care patients. AIM:To a...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/01.meg.0000216942.42306.d5
更新日期:2007-07-01 00:00:00
abstract:AIM:A combination of omeprazole plus amoxycillin (Amo) and clarithromycin (CIa) for 7 days has been studied extensively. However, the role of other proton pump inhibitors, such as pantoprazole (Pan), in this therapy is not well known. On the other hand, ranitidine bismuth citrate (RBC) also seems to be effective when c...
journal_title:European journal of gastroenterology & hepatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00042737-200012050-00003
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVES:Data on heredity, risk factors and comorbidity in microscopic colitis, encompassing collagenous colitis (CC) and lymphocytic colitis (LC), are limited. AIM:The aim was to carry out a case-control study of family history, childhood circumstances, educational level, marital status, smoking and comorbidity in ...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/MEG.0000000000000832
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Mass screening programmes in Europe and in the USA have shown that a 15-18% decrease in mortality rate from colo-rectal cancer can be achieved with biannual testing. In a 10 year screening programme in the Isère region (France), we have noticed that the positivity percentage of Hemoccult II changes significa...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/00042737-200310000-00008
更新日期:2003-10-01 00:00:00
abstract::We describe a 55-year-old patient with alcoholic chronic pancreatitis, a large mediastinal pseudocyst and a hemorrhagic pleural effusion. A single thoracocentesis and withdrawal of alcohol without other conservative or invasive measures resulted in a complete resolution of the pleural effusion and the mediastinal pseu...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/00042737-200601000-00020
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:Recent studies have suggested that endotoxin-induced cytokines play an important role in nonalcoholic fatty liver disease (NAFLD). Rifaximin is a nonabsorbable antibiotic that might act on Gram-negative bacteria, thereby inhibiting endotoxin proinflammatory cytokine production in patients with NAFLD. Our aim ...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/MEG.0000000000000348
更新日期:2015-07-01 00:00:00
abstract::Oesophageal stenting for palliation of malignant obstruction with self-expanding metallic stents is undoubtedly well established. Numerous studies have proven it to be safe and easy to perform with good clinical outcomes. However, stenting of the upper oesophagus is still regarded with apprehension, with many endoscop...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/MEG.0b013e3283496543
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:An inappropriate mucosal immune response to the commensal bacterial flora may play a role in the pathogenesis of inflammatory bowel disease (IBD). In this study we determined the percentage of immunoglobulin-coated bacteria in the stools of patients and controls. METHODS:Faecal samples were obtained from 18 ...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/01.meg.0000108346.41221.19
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND AND AIMS:Echo-enhanced power Doppler sonography is an increasingly used procedure for the differentiation of liver tumours. The aim of this prospective study was to investigate the accuracy of echo-enhanced power Doppler sonography in comparison with conventional ultrasound and fundamental power Doppler sono...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/00042737-200308000-00010
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Serum biomarkers of steatosis such as the SteatoTest are recommended for large-scale screening studies, because imaging is less accessible and more expensive. AIMS:The primary aim of this retrospective analysis of prospective studies was to construct a new SteatoTest-2 that was not inferior to the reference...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/MEG.0000000000001304
更新日期:2019-03-01 00:00:00
abstract::Malignant pericardial effusion is an uncommon disorder and is usually caused by far advanced lung cancer, breast cancer, lymphoma and leukaemia. Pericardial effusion in recurrent gastric cancer has been reported in only three patients. We report the case of a 53-year-old male with sudden onset of dyspnoea, pericardial...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/00042737-199807000-00018
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:Although small bowel capsule endoscopy (SBCE) has developed an established role in Crohn's disease (CD), there is paucity of data on impact of SBCE on subsequent management. We investigated the clinical utility of SBCE in patients with suspected and established CD and inflammatory bowel disease unclassified ...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/MEG.0b013e32835ddb85
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:Hepcidin is an endogenous antimicrobial peptide with a key role in iron homoeostasis. Hepcidin is similar to defensin, the deficiency of which is associated with Crohn's disease. To date there has been no validated method to reliably assay serum hepcidin. We studied iron indices in inflammatory bowel disease ...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/MEG.0b013e32830e2885
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVES:The prognostic value of p53 protein accumulation in colonic adenomas is still controversial. The aim of the present study was to determine whether the evaluation of p53 protein accumulation in newly diagnosed colonic adenomas could predict the development of metachronous adenomas. DESIGN/METHODS:Fifty-five ...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/00042737-199905000-00014
更新日期:1999-05-01 00:00:00
abstract::Concomitant functional dyspepsia (FD) and psychosocial stressors have been reported; however, the association between FD and depression remains controversial and no quantitative meta-analysis exists. Published articles were identified through a comprehensive review of PubMed, Embase, and Web of Science from inception ...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MEG.0000000000001451
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:The red blood cell distribution width (RDW) has been reported to be a risk marker of morbidity and mortality for cardiovascular diseases in various study populations. Nonalcoholic fatty liver disease (NAFLD) is also a risk factor for cardiovascular diseases. However, the relationship between RDW and NAFLD is...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/MEG.0b013e328365c403
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The response to immunosuppressive therapy in autoimmune hepatitis (AIH) is a matter of debate. The aim of this work is to identify the histological, biochemical, and clinical predictive factors of incomplete response/treatment failure to the standard treatment (prednisone with or without azath...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/MEG.0000000000000982
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:To investigate gallbladder function by use of cholescintigraphy in patients with acute cholecystitis before and after percutaneous gallbladder drainage. DESIGN:A cholescintigraphy was performed in 40 patients with acute cholecystitis before and after the performance of percutaneous gallbladder drainage. Duri...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/00042737-199511000-00013
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:The detection of bacterial DNA in serum and ascitic fluid from patients with cirrhosis and ascites is interpreted as molecular evidence of intestinal bacterial translocation and considered sufficient to activate the cellular immune response. In vitro studies on ascitic fluid culture have shown a close relati...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/00042737-200501000-00010
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:Although antimony electrodes are by far the most popular for performing oesophageal pH monitoring, there are few data comparing the accuracy of glass and antimony electrodes. Therefore, we tested the accuracy of both electrodes in the prediction of oesophagitis. METHOD:pH monitoring using a glass electrode a...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/00042737-200412000-00015
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of transcutaneous electrical nerve stimulation (TENS) on intraductal biliary pressure (IDP) in basal conditions and after intravenous morphine and oral meal stimulation. DESIGN AND METHODS:Fifteen patients (5 male, 10 female) aged 31-83 years (mean 61.5 +/- 13.7 years) with prior chol...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/00042737-200301000-00005
更新日期:2003-01-01 00:00:00
abstract::Detection and characterization of all focal lesions in the liver are critical for screening patients with chronic liver disease. The aim of this prospective study was to investigate the accuracy of magnetic resonance imaging (MRI) and spiral computed tomography for the diagnosis of hepatic nodules in cirrhotic patient...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/00042737-200202000-00010
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:Increasing attention is paid to measure patient's experience using specific patient-reported experience measures (PREMs) as tool to assess the overall quality of care provided. The European Society of Gastrointestinal Endoscopy and the United European Gastroenterology have recognized the measure of quality of...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/MEG.0000000000001957
更新日期:2020-10-29 00:00:00
abstract::Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease. Frequently, it can slowly progress to cirrhosis and, finally, death. Liver transplantation is the only way to avoid this endpoint. For patients not accepted for liver transplantation, only symptomatic treatment remains. In advanced PBC, one of the...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/00042737-199908000-00021
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:In the era of screening colonoscopy, assessment of operator competence is warranted. AIM:To evaluate feasibility of a computer simulator (CS) use for assessment of competence in colonoscopy by investigating performance of expert endoscopists at CS. SUBJECTS:Twenty expert endoscopists involved in screening ...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章,多中心研究
doi:10.1097/MEG.0b013e32832ad615
更新日期:2010-01-01 00:00:00