Do proton pump inhibitors (PPI) use with acetyl salicylic acid (ASA) reduce the effect in stroke patients proflaksi ?

Stroke is the third most common cause of deaths in all the world after coronary heart disease and cancer. Fighting with risk factors as hypertension, diabetes, hypercholesterolemia, smoking is important to avoid stroke. In addition to these prophylactic drug therapy has a important role. Acetyl salicylic acid (ASA) and clopidogrel (antiplatelet) are the most widely used and proven effectiveness drugs for prophylaxis of ischemic stroke. ASA commonly used with PPIs because of its adverse effects on gastro-intestinal tract. In this study our purpose was to determine whether the usage of lansoprazole with ASA decreases the antiaggregant efficiency of ASA or not. Antiplatelet activity evaluated with impedance aggregometer method in patients use just ASA and patients use ASA with 30 mg lansoprazole. Hundred ninety-nine patients who are using 100 mg ASA because of stroke/transient ischemic attack checked for aspirin resistance and 57 patients excluded from the study because of aspirin resistance. 75 of 142 patients had dyspeptic complaints and they started to use 30 mg lansoprazole because of it. Blood samples were taken from both groups and analyzed for ASA resistance. Resistance was broken after dose increment in patients who have low resistance. In present study it shown using 30 mg lansoprazole with 100 mg ASA not caused reduction in antiaggregant activity and patients have low resistance can benefit by dose increment. Nevertheless, repetition in larger groups will increase the reliability of this results because of the low number of resistance in our study. On the other hand, in present study the duration of using antiaggregant were shorter than one year. Because of that, long-term studies are needed to determine late effects