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2 results on '"protonpompremmers"'

1. The challenge of Cardiovascular Disease: the role of Magnesium

Author

Vermeulen, Emma Alexia and Vermeulen, Emma Alexia

Abstract

The prevalence of chronic kidney disease (CKD) is estimated to be 10% among the adult population worldwide, with currently approximately 1,7 million people with CKD in the Netherlands. People with CKD are at increased risk of not only progression of CKD, but even more importantly, they face an increased risk of cardiovascular disease (CVD) and mortality, which is 2 to 4 times higher compared to healthy individuals. Among the main causes of this increased cardiovascular risk in people with CKD are disturbed mineral metabolism and accelerated vascular calcification. Therefore, it is of importance to investigate approaches on how to retard or even prevent the process of vascular pathology. Management of known cardiovascular risk factors, such as hypertension, obesity, smoking, an inactive lifestyle etc. only leads to a moderate reduction of the cardiovascular risk. Consequently, identifying and managing other targets that could reduce the risk of CVD is of importance for people with CKD. In an effort to do so, the NIGRAM(2+) consortium focussed on the role of the mineral magnesium. The hypothesis of a role for magnesium is based on several in vitro and animal studies that have demonstrated that higher magnesium intake and high serum magnesium levels can inhibit vascular calcification, improve vascular function and reduce chronic inflammation. Also, an inverse association between magnesium and CVD and mortality has consistently been demonstrated in various cohorts. At present, magnesium intervention trials that investigate the effect of magnesium supplementation on parameters of cardiovascular health are limited and demonstrate inconsistent results. This thesis focuses on serum magnesium concentration and magnesium intake in clinical research, practicing a wide variety of epidemiological approaches. We aim to investigate if the inverse association between magnesium and CVD and mortality is present in different populations, including people with CKD, type 2 diabetes and

Published
2024
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2. Pantoprazole in Patients at Risk for Gastrointestinal Bleeding in the ICU

Author

Krag, Mette, Marker, Søren, Perner, Anders, Wetterslev, Jørn, Wise, Matt P, Schefold, Joerg C, Keus, Frederik, Guttormsen, Anne B, Bendel, Stepani, Borthwick, Mark, Lange, Theis, Rasmussen, Bodil S, Siegemund, Martin, Bundgaard, Helle, Elkmann, Thomas, Jensen, Jacob V, Nielsen, Rune D, Liboriussen, Lisbeth, Bestle, Morten H, Elkjær, Jeanie M, Palmqvist, Dorte F, Bäcklund, Minna, Laake, Jon H, Bådstøløkken, Per M, Grönlund, Juha, Breum, Olena, Walli, Akil, Winding, Robert, Iversen, Susanne, Jarnvig, Inge-Lise, White, Jonathan O, Brand, Björn, Madsen, Martin B, Quist, Lars, Thornberg, Klaus J, Møller, Anders, Wiis, Jørgen, Granholm, Anders, Anthon, Carl T, Meyhoff, Tine S, Hjortrup, Peter B, Aagaard, Søren R, Andreasen, Jo B, Sørensen, Christina A, Haure, Pernille, Hauge, Jacob, Hollinger, Alexa, Scheuzger, Jonas, Tuchscherer, Daniel, Vuilliomenet, T, Takala, J, Jakob, S. M., Vang, M. L., Pælestik, K. B., Andersen, K. L. D., van der Horst, I. C. C., Dieperink, W., Fjølner, J., Kjer, C. K. W., Sølling, C, Sølling, C. G., Karttunen, J., Morgan, M. P. G., Sjøbø, B., Engstrøm, J., Agerholm-Larsen, B, Møller, Morten H, Rasmussen, Bodil Steen, Aagaard, Søren Rosborg, Bønding Andreasen, Jo, Ankjær Sørensen, Christina, Christensen, Pernille Haure, Levin, Marianne, Klemmesen Jensen, Käte, Lundberg, Lillian Skov Søndergaard, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Cardiovascular Centre (CVC), and Critical Care

Subjects
Pantoprazole/adverse effects, Male, INTENSIVE-CARE-UNIT, intraveneuze injecties, law.invention, Proton Pump Inhibitors/adverse effects, intensive care afdelingen, 0302 clinical medicine, Randomized controlled trial, law, overlevingsanalyse, Risk Factors, adults, Medicine, maagzweren, Artikkel, Single-Blind Method, 030212 general & internal medicine, 610 Medicine & health, Pantoprazole, enkele blindering, volwassenen, General Medicine, Middle Aged, Intensive care unit, Intensive Care Units, Injections, Intravenous, STRESS-ULCER PROPHYLAXIS, Female, psychosocial stress, Gastrointestinal Hemorrhage, kritieke ziekte, medicine.drug, medicine.medical_specialty, Gastrointestinal bleeding, risicofactoren, Peptic Ulcer, Randomization, bijwerkingen, Gastrointestinal Hemorrhage/epidemiology, Critical Illness, Placebo, Peptic Ulcer/prevention & control, psychosociale stress, PROTON-PUMP INHIBITORS, 03 medical and health sciences, Medisinske Fag: 700 [VDP], Stress, Physiological, Internal medicine, SCORE, Humans, VDP::Medisinske Fag: 700, Aged, gastro-intestinale bloeding, SEPSIS, business.industry, intravenous injections, 030208 emergency & critical care medicine, Proton Pump Inhibitors, pantaprazole, ta3121, medicine.disease, Survival Analysis, Confidence interval, Critical Illness/mortality, Relative risk, adverse effects, business, single-blind methoden, protonpompremmers
Abstract

Background\ud\udProphylaxis for gastrointestinal stress ulceration is frequently given to patients in the intensive care unit (ICU), but its risks and benefits are unclear.\udMethods\ud\udIn this European, multicenter, parallel-group, blinded trial, we randomly assigned adults who had been admitted to the ICU for an acute condition (i.e., an unplanned admission) and who were at risk for gastrointestinal bleeding to receive 40 mg of intravenous pantoprazole (a proton-pump inhibitor) or placebo daily during the ICU stay. The primary outcome was death by 90 days after randomization.\udResults\ud\udA total of 3298 patients were enrolled; 1645 were randomly assigned to the pantoprazole group and 1653 to the placebo group. Data on the primary outcome were available for 3282 patients (99.5%). At 90 days, 510 patients (31.1%) in the pantoprazole group and 499 (30.4%) in the placebo group had died (relative risk, 1.02; 95% confidence interval [CI], 0.91 to 1.13; P=0.76). During the ICU stay, at least one clinically important event (a composite of clinically important gastrointestinal bleeding, pneumonia, Clostridium difficile infection, or myocardial ischemia) had occurred in 21.9% of patients assigned to pantoprazole and 22.6% of those assigned to placebo (relative risk, 0.96; 95% CI, 0.83 to 1.11). In the pantoprazole group, 2.5% of patients had clinically important gastrointestinal bleeding, as compared with 4.2% in the placebo group. The number of patients with infections or serious adverse reactions and the percentage of days alive without life support within 90 days were similar in the two groups.\udConclusions\ud\udAmong adult patients in the ICU who were at risk for gastrointestinal bleeding, mortality at 90 days and the number of clinically important events were similar in those assigned to pantoprazole and those assigned to placebo. (Funded by Innovation Fund Denmark and others; SUP-ICU ClinicalTrials.gov number, NCT02467621. opens in new tab.)

Published
2018
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