Adverse events in patients with cardiovascular disease taking proton pump inhibitors.

IF 3 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Expert Opinion on Drug Safety Pub Date : 2024-11-01 Epub Date: 2024-10-28 DOI:10.1080/14740338.2024.2409702
Aitor Lanas-Gimeno, Ángel Lanas
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引用次数: 0

Abstract

Introduction: Proton pump inhibitors (PPIs) rank among the most frequently prescribed medications to treat acid-related diseases. Mounting concerns surround the potential for serious adverse events, including cardiovascular events, associated with their prolonged use/misuse.

Areas covered: This comprehensive review explores cardiovascular adverse events linked to PPI use among high-risk cardiovascular patients. A structured search was conducted on PubMed.

Expert opinion: Many patients with cardiovascular disease who require antiplatelet treatment will require long-term PPI treatment. Interpreting the published data is not straightforward. First, because there is no plausible mechanistic explanation for PPIs to induce cardiovascular events apart from the potential interaction with the metabolism of thienopyridines. Although several observational studies have shown an increased cardiovascular risk and mortality in patients taking long-term PPIs, most available clinical trials and meta-analyses of available studies do not. However, the absence of firm evidence of this link does not necessarily imply that this association does not exist, and other hypothesis must be explored. Anemia is a common event in patients who take antiplatelet therapy and PPIs, and it is a factor associated with cardiovascular events and death. Anemia in these patients is often attributed to erosive lesions of the small intestine, where PPI may play a key role by modifying the microbiota.

服用前列腺素泵抑制剂的心血管疾病患者的不良反应。
导言:质子泵抑制剂(PPIs)是治疗胃酸相关疾病最常用的处方药之一。人们越来越关注长期使用/滥用这些药物可能导致的严重不良事件,包括心血管事件:本综述探讨了与高危心血管患者使用 PPI 相关的心血管不良事件。在PubMed上进行了结构化检索:许多需要抗血小板治疗的心血管疾病患者需要长期服用 PPI。解读已发表的数据并不简单。首先,除了与噻吩并吡啶类药物代谢的潜在相互作用外,PPIs 诱发心血管事件并没有合理的机理解释。虽然有几项观察性研究显示长期服用 PPIs 的患者心血管风险和死亡率会增加,但大多数现有的临床试验和对现有研究的荟萃分析都没有显示出这一点。然而,没有确凿证据证明这种联系并不一定意味着这种联系不存在,还必须探索其他假设。贫血是服用抗血小板疗法和 PPIs 患者的常见病,也是心血管事件和死亡的相关因素之一。这些患者贫血的原因通常是小肠侵蚀性病变,而 PPI 可能通过改变微生物群起到关键作用。
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
CiteScore
5.90
自引率
3.20%
发文量
97
审稿时长
6-12 weeks
期刊介绍: Expert Opinion on Drug Safety ranks #62 of 216 in the Pharmacology & Pharmacy category in the 2008 ISI Journal Citation Reports. Expert Opinion on Drug Safety (ISSN 1474-0338 [print], 1744-764X [electronic]) is a MEDLINE-indexed, peer-reviewed, international journal publishing review articles on all aspects of drug safety and original papers on the clinical implications of drug treatment safety issues, providing expert opinion on the scope for future development.
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