Proton pump inhibitor use and risk of stroke: A systematic review and meta-analysis.

IF 1.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Pakistan Journal of Medical Sciences Pub Date : 2024-11-01 DOI:10.12669/pjms.40.10.10409

Yaoyao Feng, Ying Zhong

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引用次数: 0

Abstract

Objective: To explore a link between the use of proton pump inhibitor (PPI) and the risk of stroke.

Methods: Comprehensive literature search in PubMed, EMBASE, and Cochrane CENTRAL Library databases was carried out for observational studies establishing the link between PPI and a risk of stroke. Data extraction and quality assessment were performed by two reviewers. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) using random-effects models were plotted. Subgroup analyses were conducted based on age, gender, PPI type, duration of follow-up, and propensity score matching (PSM).

Results: The analysis included 12 studies, with considerable heterogeneity (I2 = 95%). PPI use did not affect the incidence of ischemic stroke (HR: 1.11, 95% CI: 0.98-1.26). Subgroup analyses revealed that PPI use correlated with the risk of ischemic stroke, in particular in patients<65 years old (HR: 1.25, 95% CI: 1.07-1.45), both males (HR: 1.12, 95% CI: 1.02-1.24) and females (HR: 1.21, 95% CI: 1.10-1.33). The correlation varied depending on the PPI type, with pantoprazole showing elevated risk (HR: 1.66, 95% CI: 1.43-1.93). Duration of follow-up or propensity score matching (PSM) did not impact the association.

Conclusion: PPI use may be linked with ischemic stroke, particularly in individuals <65 years old and of all genders. The specific PPI type may also influence the risk. However, the cumulative analysis did not find any statistically significant association, and heterogeneity among studies was substantial.

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使用质子泵抑制剂与中风风险：系统回顾和荟萃分析。

目的：探讨使用质子泵抑制剂（PPI）与中风风险之间的联系：探讨使用质子泵抑制剂（PPI）与中风风险之间的联系：在 PubMed、EMBASE 和 Cochrane CENTRAL Library 数据库中进行了全面的文献检索，以寻找确定 PPI 与中风风险之间联系的观察性研究。数据提取和质量评估由两名审稿人完成。采用随机效应模型绘制了汇总的危险比 (HR) 及 95% 置信区间 (CI)。根据年龄、性别、PPI类型、随访时间和倾向评分匹配（PSM）进行了亚组分析：分析包括 12 项研究，异质性相当大（I2 = 95%）。使用 PPI 不会影响缺血性中风的发病率（HR：1.11，95% CI：0.98-1.26）。亚组分析显示，使用 PPI 与缺血性中风的风险有关，尤其是对患者而言：结论：PPI 的使用可能与缺血性中风有关，尤其是在以下人群中

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

Pakistan Journal of Medical Sciences 医学-医学：内科

CiteScore

4.10

自引率

9.10%

发文量

363

审稿时长

3-6 weeks

期刊介绍： It is a peer reviewed medical journal published regularly since 1984. It was previously known as quarterly "SPECIALIST" till December 31st 1999. It publishes original research articles, review articles, current practices, short communications & case reports. It attracts manuscripts not only from within Pakistan but also from over fifty countries from abroad. Copies of PJMS are sent to all the import medical libraries all over Pakistan and overseas particularly in South East Asia and Asia Pacific besides WHO EMRO Region countries. Eminent members of the medical profession at home and abroad regularly contribute their write-ups, manuscripts in our publications. We pursue an independent editorial policy, which allows an opportunity to the healthcare professionals to express their views without any fear or favour. That is why many opinion makers among the medical and pharmaceutical profession use this publication to communicate their viewpoint.