Do Proton Pump Inhibitors Cause Myocardial Infarction and Stroke? Time-Variant Analyses Can Resolve the Debate

Details

• Personal Author:
  Antonio RC ; Crane MA ; Dasaro CR ; Doucette JT ; Harrison DJ ; Luft BJ ; Moline JM ; Sabra A ; Sacks HS ; Shapiro MZ ; Sloan NL ; Teitelbaum SL ; Thanik E ; Todd AC ; Udasin IG
• Description:
  With broad advertisement and over-the-counter availability, global proton pump inhibitor (PPI) use is common (10%-21%) for the treatment of gastroesophageal reflux disease (GERD). Unlike histamine 2 receptor antagonists (H2RA). PPIs impair endothelial nitric oxide synthase and vascular function that lead to inflammation, GERD and thrombosis, and they may impair cardiac function. With confliction evidence, there is ongoing concern about whether PPIs increase the risk of cardiovascular disease (CVD), the leading cause of adult death and disability worldwide. Our nested case-control analyses of PPI use, and its recency and duration with first and second myocardial infarction (MI) and stroke events in the World Trade Center (WTC) General Responders Cohort, a multicenter open cohort, clarifies whether the relationship is causal. Evidence regarding the timing of PPI use and its association with CVD is scant with mixed results. Five studies assessing the timing of PPI use included patients using antiplatelet agents, which confounds the association of PPI and incident of CVD because antiplatelet agents are used for secondary prevention of recurrent CVD and treatment of other related conditions that may precipitate incident myocardial infarction and stroke. These studies are also flawed by the lack of an unexposed comparison group, comparison of cases to themselves before PPI use, or very short-term assessment of medications use that cannot fairly assess causality of chronic conditions such as CVD. [Description provided by NIOSH]
• Subjects:
  Cardiovascular Diseases Cardiovascular System Cohort Studies Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Cardiac Function Cardiovascular Disease Case Control Studies Cohort Studies Gastroesophageal Reflux Disease GERD Therapeutic Agents World Trade Center WTC
• ISSN:
  1075-2765
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Contract
• Genre:
  Journal Article
• Place as Subject:
  New Jersey ; New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  31
• Issue:
  5
• NIOSHTIC Number:
  nn:20069902
• Citation:
  Am J Ther 2024 Sep/Oct; 31(5):e573-e577
• Federal Fiscal Year:
  2024
• Performing Organization:
  State University of New York Stony Brook
• Peer Reviewed:
  False
• Start Date:
  20040715
• Source Full Name:
  American Journal of Therapeutics
• End Date:
  20110630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:acd40a6fe66875b5272808415a58e2fcda3a7c754579d39325828892f8c0614a01294f22c5b8f1d6e507a0415457fe112d36cc8e13f5adc787a54861773edd9c
• Download URL:
  https://stacks.cdc.gov/view/cdc/208236/cdc_208236_DS1.pdf
• File Type:
  [PDF - 77.80 KB ]