Do PPIs affect cardiovascular outcome in aspirin treated patients

January 01, 0001

Do PPIs affect cardiovascular outcome in aspirin treated patients

These Danish researchers tested whether proton pump inhibitor use affected rate of cardiovascular events patients on aspirin following intial myocardial infarction. They performed a retrospective nationwide propensity score matched study using administrative data from all Danish hospitals. They utilized a combined end point of cardiovascular death, myocardial infarction, or stroke. They analyzed the data with Kaplan-Meier analysis, Cox proportional hazard models, and propensity score matched Cox proportional hazard models.

The researchers found: "3366 of 19?925 (16.9%) aspirin treated patients experienced recurrent myocardial infarction, stroke, or cardiovascular death. The hazard ratio for the combined end point in patients receiving proton pump inhibitors based on the time dependent Cox proportional hazard model was 1.46 and for the propensity score matched model based on 8318 patients it was 1.61. A sensitivity analysis showed no increase in risk related to use of H2 receptor blockers (1.04)."

The researchers concluded: "In aspirin treated patients with first time myocardial infarction, treatment with proton pump inhibitors was associated with an increased risk of adverse cardiovascular events."

This study suggests the use of proton pump inhibitors increases risk of cardiovascular events in patients on aspirin following incident myocardial infarction.

For the full abstract, click here.

BMJ 342:d2690, 11 May 2011
© 2011 BMJ Publishing Group Ltd.
Proton pump inhibitor use and risk of adverse cardiovascular events in aspirin treated patients with first time myocardial infarction: nationwide propensity score matched study. Mette Charlot, Erik L Grove, Peter Riis Hansen, et al. Correspondence to M Charlot: [email protected]

Category: D. Digestive, K. Circulatory. Keywords: proton pump inhibitor, aspirin, myocardial infarction, stroke, mortality, retrospective nationwide propensity score matched study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 31 May 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.