Use of proton-pump inhibitors predicts heart failure and death in patients with coronary artery disease
Author
Pello, Ana María; Cristóbal, Carmen; Franco-Peláez, Juan Antonio; Tarín, Nieves; Aceña Navarro, Álvaro; Carda, Rocío; Huelmos, Ana; Martín-Mariscal, María Luisa; Fuentes-Antras, Jesús; Martínez-Milla, Juan; Alonso, Joaquín; Lorenzo González, Óscar; Egido, Jesús; López-Bescós, Lorenzo; Tuñón Fernández, José LuisEntity
UAM. Departamento de Medicina; Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD)Publisher
Public Library of ScienceDate
2017-01-19Citation
10.1371/ journal.pone.0169826
PLoS ONE 12.1 (2017): e0169826
ISSN
1932-6203DOI
10.1371/ journal.pone.0169826Funded by
This work was supported by grants from Fondo de Investigaciones Sanitarias [grant numbers PI 14/1567, PI13/00047, PIE13/00051], ISCIII-RETIC REDinREN RD12/0021, Comunidad de Madrid [sGEN/0247/2006, S2010/BMD-2378], Spanish Society of Cardiology; Spanish Heart Foundation; RECAVA [grant number RD06/0014/0035]; Instituto de Salud Carlos III FEDER [FJD biobank grant number RD09/0076/00101]Project
Comunidad de Madrid. sGEN/0247/2006; Comunidad de Madrid. S2010/BMD-2378/CIFRA; Gobierno de España. PI14/1567; Gobierno de España. PI13/00047; Gobierno de España. PIE13/00051Editor's Version
https://doi.org/10.1371/ journal.pone.0169826Subjects
Proton.pump inhibitors; Patients; Coronary artery disease; Heart failure; Death; MedicinaRights
© 2017 Pello Lázaro et al.Abstract
Proton-pump inhibitors (PPIs) seem to increase the incidence of cardiovascular events in
patients with coronary artery disease (CAD), mainly in those using clopidogrel. We analysed
the impact of PPIs on the prognosis of patients with stable CAD.
Methods
We followed 706 patients with CAD. Primary outcome was the combination of secondary
outcomes. Secondary outcomes were 1) acute ischaemic events (any acute coronary syndrome,
stroke, or transient ischaemic attack) and 2) heart failure (HF) or death.
Results
Patients on PPIs were older [62.0 (53.0±73.0) vs. 58.0 (50.0±70.0) years; p = 0.003] and
had a more frequent history of stroke (4.9% vs. 1.1%; p = 0.004) than those from the non-
PPI group, and presented no differences in any other clinical variable, including cardiovascular
risk factors, ejection fraction, and therapy with aspirin and clopidogrel. Follow-up was
2.2±0.99 years. Seventy-eight patients met the primary outcome, 53 developed acute
ischaemic events, and 33 HF or death. PPI use was an independent predictor of the primary
outcome [hazard ratio (HR) = 2.281 (1.244±4.183); p = 0.008], along with hypertension,
body-mass index, glomerular filtration rate, atrial fibrillation, and nitrate use. PPI use was
also an independent predictor of HF/death [HR = 5.713 (1.628±20.043); p = 0.007], but not
of acute ischaemic events. A propensity score showed similar results.
Conclusions
In patients with CAD, PPI use is independently associated with an increased incidence of
HF and death but not with a high rate of acute ischaemic events. Further studies are needed to confirm these findings
Files in this item
Google Scholar:Pello, Ana María
-
Cristóbal, Carmen
-
Franco-Peláez, Juan Antonio
-
Tarín, Nieves
-
Aceña Navarro, Álvaro
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Carda, Rocío
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Huelmos, Ana
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Martín-Mariscal, María Luisa
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Fuentes-Antras, Jesús
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Martínez-Milla, Juan
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Alonso, Joaquín
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Lorenzo González, Óscar
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Egido, Jesús
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López-Bescós, Lorenzo
-
Tuñón Fernández, José Luis
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