Long-Term Effects of Proton Pump Inhibitors in Patients Undergoing Percutaneous Coronary Intervention in High-Risk Subgroups.

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Circulation Journal Pub Date : 2024-08-06 DOI:10.1253/circj.CJ-24-0371

Ko Yamamoto, Erika Yamamoto, Takeshi Morimoto, Hiroki Shiomi, Takenori Domei, Ryoji Taniguchi, Hiroshi Sakai, Mamoru Toyofuku, Shuichiro Kaji, Ryuzo Nawada, Takafumi Yokomatsu, Satoru Suwa, Yutaka Furukawa, Kazushige Kadota, Kenji Ando, Takeshi Kimura

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引用次数: 0

Abstract

Background: Proton pump inhibitors (PPIs) reportedly reduce upper gastrointestinal bleeding (UGIB) in patients undergoing percutaneous coronary intervention (PCI). However, whether the benefits of PPIs differ in high-risk subgroups is unknown.

Methods and results: Among 24,563 patients undergoing first PCI in the CREDO-Kyoto registry Cohort-2 and -3, we evaluated long-term effects of PPI for UGIB, defined as GUSTO moderate/severe bleeding, in several potential high-risk subgroups. In the study population, 45.6% of patients were prescribed PPIs. Over a median 5.6-year follow-up, PPIs were associated with lower adjusted risk of UGIB (hazard ratio [HR] 0.64; 95% confidence interval [CI] 0.50-0.80; P<0.001) and a non-significant but numerically lower risk of any gastrointestinal bleeding (HR 0.84; 95% CI 0.71-1.01; P=0.06). PPIs were not associated with a lower risk of GUSTO moderate/severe bleeding (HR 1.04; 95% CI 0.94-1.15; P=0.40) or a higher adjusted risk of myocardial infarction or ischemic stroke (HR 1.00; 95% CI 0.90-1.12; P=0.97), but were associated with higher adjusted mortality risk (HR 1.18; 95% CI 1.09-1.27; P<0.001). The effects of PPIs for UGIB, myocardial infarction or ischemic stroke, and all-cause death were consistent regardless of age, sex, acute coronary syndrome, high bleeding risk, oral anticoagulant use, and type of P2Y₁₂inhibitor.

Conclusions: PPIs were associated with a lower risk of UGIB and a neutral risk of ischemic events regardless of high-risk subgroup.

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质子泵抑制剂对接受经皮冠状动脉介入治疗的高风险亚组患者的长期影响。

背景：据报道，质子泵抑制剂（PPI）可减少经皮冠状动脉介入治疗（PCI）患者的上消化道出血（UGIB）。然而，在高风险亚组中，PPIs 的益处是否有所不同尚不清楚：在 CREDO-Kyoto 登记队列-2 和-3 的 24,563 名首次接受 PCI 的患者中，我们评估了 PPI 治疗 UGIB（定义为 GUSTO 中度/重度出血）的长期效果，其中包括几个潜在的高风险亚组。在研究人群中，45.6% 的患者接受了 PPI 治疗。在中位 5.6 年的随访中，PPI 与较低的 UGIB 调整风险相关（危险比 [HR] 0.64；95% 置信区间 [CI] 0.50-0.80；P12inhibitor.Conclusions：结论：无论高风险亚组如何，PPIs 与较低的 UGIB 风险和中性的缺血性事件风险相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Circulation Journal 医学-心血管系统

CiteScore

5.80

自引率

12.10%

发文量

471

审稿时长

1.6 months

期刊介绍： Circulation publishes original research manuscripts, review articles, and other content related to cardiovascular health and disease, including observational studies, clinical trials, epidemiology, health services and outcomes studies, and advances in basic and translational research.