Omeprazole: A Possible New Candidate Influencing the Antiplatelet Effect of ClopidogrelEditorials published in the Journal of the American College of Cardiology reflect the views of the authors and do not necessarily represent the views of JACC or the American College of Cardiology

[...]because the primary premise of this study is that the omeprazole-clopidogrel drug-drug interaction is via a CYP2C19 competitive or noncompetitive inhibitory mechanism, all known patients with CYP2C19 polymorphism should be excluded. Because heterozygous CYP2C19*2(*1/*2) genetic polymorphism leads to substantial decrease in the phenotypic expression of CYP2C19 as compared to the wild-type CYP2C19 (1*/1) with the incidence of CYP2C19*2 polymorphism ~29% (19), excluding all patients with CYP2C19 polymorphism would ensure that the difference observed in platelet reactivity between the 2 groups is not due to more patients with the CYP2C19 polymorphism in the omeprazole + clopidogrel group. [...]there are emerging data from overall small studies (21) demonstrating heightened thrombotic risk in patients with high platelet reactivity to ADP following coronary stenting.