{"title":"Gastroprotection in Heart Failure and Outcomes: A Systematic Review of Proton Pump Inhibitors and Histamine-2 Receptor Antagonists.","authors":"Mustafa Eray Kilic, Mehmet Birhan Yilmaz","doi":"10.1007/s10557-024-07660-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The management of heart failure (HF) frequently includes gastroprotection via proton pump inhibitors (PPIs) or histamine-2 receptor antagonists (H2RAs). This systematic review evaluates their impact on HF outcomes, including exacerbation, hospitalization, mortality, and major adverse cardiac events (MACE).</p><p><strong>Methods: </strong>In accordance with PRISMA guidelines, a complete search across databases such as PubMed/Medline, Scopus, and Web of Science was conducted until December 10, 2023. The inclusion criteria covered research on adult patients with HF that focused on the effects of PPI and H2RA usage. The risk of bias was determined via the Newcastle-Ottawa Scale (NOS), and data were synthesized quantitatively.</p><p><strong>Results: </strong>Eleven studies encompassing 996,498 participants were analyzed. The data is not consistent across all research; however, some have suggested that PPI use may be linked to an increased risk of cardiovascular illnesses and heart failure aggravation. Conversely, H2RAs appeared to offer potential benefits in certain high-risk groups, potentially reducing all-cause and cardiovascular mortality. However, the limitations of the available studies should be taken into consideration when interpreting these findings.</p><p><strong>Conclusion: </strong>The review suggests that there may be differences in the impact of PPIs and H2RAs on HF outcomes. While some evidence indicates that PPIs may be linked to increased risks in HF patients, and H2RAs may offer potential benefits, these findings are not definitive and should be interpreted with caution. Further research is necessary to clarify these associations and guide clinical practice.</p><p><strong>Registration: </strong>PROSPERO CRD42023491752.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Drugs and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10557-024-07660-3","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The management of heart failure (HF) frequently includes gastroprotection via proton pump inhibitors (PPIs) or histamine-2 receptor antagonists (H2RAs). This systematic review evaluates their impact on HF outcomes, including exacerbation, hospitalization, mortality, and major adverse cardiac events (MACE).
Methods: In accordance with PRISMA guidelines, a complete search across databases such as PubMed/Medline, Scopus, and Web of Science was conducted until December 10, 2023. The inclusion criteria covered research on adult patients with HF that focused on the effects of PPI and H2RA usage. The risk of bias was determined via the Newcastle-Ottawa Scale (NOS), and data were synthesized quantitatively.
Results: Eleven studies encompassing 996,498 participants were analyzed. The data is not consistent across all research; however, some have suggested that PPI use may be linked to an increased risk of cardiovascular illnesses and heart failure aggravation. Conversely, H2RAs appeared to offer potential benefits in certain high-risk groups, potentially reducing all-cause and cardiovascular mortality. However, the limitations of the available studies should be taken into consideration when interpreting these findings.
Conclusion: The review suggests that there may be differences in the impact of PPIs and H2RAs on HF outcomes. While some evidence indicates that PPIs may be linked to increased risks in HF patients, and H2RAs may offer potential benefits, these findings are not definitive and should be interpreted with caution. Further research is necessary to clarify these associations and guide clinical practice.
期刊介绍：
Designed to objectively cover the process of bench to bedside development of cardiovascular drug, device and cell therapy, and to bring you the information you need most in a timely and useful format, Cardiovascular Drugs and Therapy takes a fresh and energetic look at advances in this dynamic field.
Homing in on the most exciting work being done on new therapeutic agents, Cardiovascular Drugs and Therapy focusses on developments in atherosclerosis, hyperlipidemia, diabetes, ischemic syndromes and arrhythmias. The Journal is an authoritative source of current and relevant information that is indispensable for basic and clinical investigators aiming for novel, breakthrough research as well as for cardiologists seeking to best serve their patients.
Providing you with a single, concise reference tool acknowledged to be among the finest in the world, Cardiovascular Drugs and Therapy is listed in Web of Science and PubMed/Medline among other abstracting and indexing services. The regular articles and frequent special topical issues equip you with an up-to-date source defined by the need for accurate information on an ever-evolving field. Cardiovascular Drugs and Therapy is a careful and accurate guide through the maze of new products and therapies which furnishes you with the details on cardiovascular pharmacology that you will refer to time and time again.
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