{"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.
目的：心力衰竭（HF）的治疗通常包括通过质子泵抑制剂（PPIs）或组胺-2受体拮抗剂（H2RAs）来保护胃。本系统综述评估了它们对心衰结局的影响，包括恶化、住院、死亡率和主要不良心脏事件（MACE）。方法：根据PRISMA指南，对PubMed/Medline、Scopus和Web of Science等数据库进行完整检索，直至2023年12月10日。纳入标准涵盖了对成年心衰患者的研究，重点关注PPI和H2RA使用的影响。通过纽卡斯尔-渥太华量表（NOS）确定偏倚风险，并对数据进行定量综合。结果：11项研究共分析了996,498名参与者。所有研究的数据并不一致；然而，一些人认为PPI的使用可能与心血管疾病和心力衰竭加重的风险增加有关。相反，H2RAs似乎对某些高危人群有潜在的益处，可能降低全因死亡率和心血管死亡率。然而，在解释这些发现时，应考虑到现有研究的局限性。结论：本综述提示PPIs和H2RAs对HF结局的影响可能存在差异。虽然一些证据表明PPIs可能与HF患者的风险增加有关，并且H2RAs可能提供潜在的益处，但这些发现并不确定，应谨慎解释。需要进一步的研究来澄清这些关联并指导临床实践。注册号：PROSPERO CRD42023491752。
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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