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Proton pump inhibitor use represents an independent risk factor for myocardial infarction
- Source :
- International journal of cardiology. 177(1)
- Publication Year :
- 2014
-
Abstract
- Background There is substantial debate regarding the development of acute coronary syndrome in patients using proton pump inhibitors (PPIs) combined with clopidogrel. However, data remain limited to address the effect of PPIs alone on the subsequent risk of myocardial infarction (MI). We aimed to explore the subsequent risk of MI in PPI users who had no previous history of MI. Methods The records of inpatients and outpatients with PPI prescriptions were retrieved from the Taiwan National Health Insurance Research Database between 2000 and 2009. We conducted two different study designs, the first using propensity score (PS)-matching analyses and the second using case-crossover analyses. The risk of developing MI for PPI users was analyzed in the PS-matched study. The association between risk of MI and prior PPI exposure was further validated in the case-crossover study. Results In the PS-matched study, we included 126,367 PPI users and 126,367 PS-matched PPI non-users. After 120days of follow-up, PPI use was associated with a 1.58-fold greater risk of MI (adjusted hazard ratio [HR]=1.58, 95% confidence interval [CI]=1.11 to 2.25). In the case-crossover study, adjusted odds ratios of PPI for MI risk were 4.61 (95% CI=1.76 to 12.07) for the 7-day window and 3.47 (95% CI=1.76 to 6.83) for the 14-day window. Conclusions Use of PPIs may be independently associated with an increased risk of MI. However, the benefits of PPIs may greatly outweigh the risks of adverse cardiovascular effects, with number needed to harm of 4357.
- Subjects :
- Adult
Male
medicine.medical_specialty
Acute coronary syndrome
Adolescent
Myocardial Infarction
Taiwan
Young Adult
Risk Factors
Internal medicine
medicine
Humans
Myocardial infarction
Risk factor
Propensity Score
Aged
Proportional Hazards Models
Retrospective Studies
Aged, 80 and over
Cross-Over Studies
business.industry
Incidence
Hazard ratio
Proton Pump Inhibitors
Odds ratio
Number needed to harm
Middle Aged
Clopidogrel
medicine.disease
Confidence interval
Surgery
Female
Cardiology and Cardiovascular Medicine
business
medicine.drug
Follow-Up Studies
Subjects
Details
- ISSN :
- 18741754
- Volume :
- 177
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- International journal of cardiology
- Accession number :
- edsair.doi.dedup.....67d8a65d5a1bfe220db90168bef04367