Volume 374, Issue 9694, Pages 989-997 (September 2009) Pharmacodynamic effect and clinical efficacy of clopidogrel and prasugrel with or without a proton-pump inhibitor: an analysis of two randomised trials  Dr Michelle L O'Donoghue, MD, Prof Eugene Braunwald, MD, Prof Elliott M Antman, MD, Sabina A Murphy, MPH, Prof Eric R Bates, MD, Prof Yoseph Rozenman, MD, Alan D Michelson, MD, Raymond W Hautvast, MD, Peter N Ver Lee, MD, Sandra L Close, PhD, Lei Shen, PhD, Jessica L Mega, MD, Marc S Sabatine, MD, Stephen D Wiviott, MD  The Lancet  Volume 374, Issue 9694, Pages 989-997 (September 2009) DOI: 10.1016/S0140-6736(09)61525-7 Copyright © 2009 Elsevier Ltd Terms and Conditions

Figure 1 Mean inhibition of platelet aggregation Inhibition of platelet aggregation (IPA) to 20 μM ADP at prespecified timepoints after a 600 mg loading dose of clopidogrel or 60 mg loading dose of prasugrel stratified by the use of a PPI in the PRINCIPLE-TIMI 44 trial. PPI=proton-pump inhibitor. *p<0·05 for comparison between users and non-users of a PPI. The Lancet 2009 374, 989-997DOI: (10.1016/S0140-6736(09)61525-7) Copyright © 2009 Elsevier Ltd Terms and Conditions

Figure 2 Proportion of non-responders (defined as IPA<20% to 20 μM ADP) 6 h (A) and 15 days (B) after clopidogrel or prasugrel and stratified by the use of a PPI in PRINCIPLE-TIMI 44 PPI=proton-pump inhibitor. IPA=inhibition of platelet aggregation. The Lancet 2009 374, 989-997DOI: (10.1016/S0140-6736(09)61525-7) Copyright © 2009 Elsevier Ltd Terms and Conditions

Figure 3 Unadjusted cumulative incidence of CV death, MI, or stroke through long-term follow-up Patients were or were not on a PPI in combination with clopidogrel or prasugrel in the TRITON-TIMI 38 trial. CV=cardiovascular. MI=myocardial infarction. PPI=proton-pump inhibitor. The Lancet 2009 374, 989-997DOI: (10.1016/S0140-6736(09)61525-7) Copyright © 2009 Elsevier Ltd Terms and Conditions