Effect of proton pump inhibitor (lansoprazole) on adverse drug reactions and rational drug use in elderly patients with chronic heart failure.

Abstract

Objective: To evaluate the efficacy and rationale of proton pump inhibitors (PPIs) for adverse drug reactions in elderly patients with heart failure (HF).

Methods: From February 2019 to September 2021, 120 elderly patients with chronic heart failure (CHF) treated at Jintan First People's Hospital were enrolled as subjects. The patients were classified into a control group (n=60) and a research group (n=60). In addition to clopidogrel, the control group received cimetidine, while the research group received lansoprazole. Clinical efficacy, oxidative stress markers, echocardiographic indices, vascular endothelial function, cardiac function indicators, and adverse reactions were compared between the two groups. A cost-effectiveness analysis was also performed, and risk factors affecting patient efficacy were examined.

Results: The clinical efficacy of the research group was remarkably superior to that of the control group (88.33% versus 63.33%, P<0.05). The combination of clopidogrel and cimetidine was identified as a risk factor affecting patient efficacy (P=0.003). Besides, the research group showed significant elevation in superoxide dismutase (SOD), glutathione peroxidase (GPx), left ventricular ejection fraction (LVEF), and nitric oxide (NO) after treatment, all higher compared to the control group (all P<0.05). Additionally, significant reductions in malondialdehyde (MDA), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic dimension (LVSD), endothelin-1 (ET-1), N-terminal pro-B-type natriuretic peptide (NT-proBNP), creatine kinase (CK), lactate dehydrogenase (LDH), and free fatty acids (FFA) were observed in the research group, all lower than the control group (P<0.05). The incidence of bradycardia, hypotension and electrolyte disturbances in the research group was remarkably lower (P<0.05). Additionally, the research group demonstrated greater cost-effectiveness compared to the control group.

Conclusion: The use of PPIs in elderly patients with HF not only improves efficacy but also enhances safety, making this drug treatment approach worth promoting.