Association between Acid-Suppressive Drugs and Clinical Outcomes in Patients with Nonvalvular Atrial Fibrillation.

IF 2.2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Drugs in Research & Development Pub Date : 2022-09-01 Epub Date: 2022-07-19 DOI:10.1007/s40268-022-00392-5

Hideki Arai, Shinichiro Ueda, Kazutaka Uchida, Fumihiro Sakakibara, Norito Kinjo, Mari Nezu, Takeshi Morimoto

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引用次数: 0

Abstract

Purpose: Acid-suppressive drugs (ASDs) are often prescribed for patients with nonvalvular atrial fibrillation (NVAF) taking oral anticoagulants (OACs). However, the risk-benefit balance of ASDs prescription for patients with NVAF taking OACs is still unclear. This study aimed to assess the association between ASDs and clinical outcomes in patients taking OACs for NVAF.

Methods: This study is a subanalysis of an historical registry study from 71 centers in Japan. We included patients taking vitamin K antagonists for NVAF and excluded those with mechanical heart valves or a history of pulmonary thrombosis or deep vein thrombosis. We registered consecutive patients in February 2013 and followed them up until February 2017. The primary outcomes were ischemic events, major bleedings, and all-cause mortality. Ischemic stroke, acute myocardial infarction, and hemorrhagic stroke comprised the secondary outcomes.

Results: We included 7826 patients with a mean age of 73 years, 5274 (67%) of whom were males. The adjusted hazard ratios (95% confidence intervals) for ischemic events, major bleedings, and all-cause mortality in the ASD group compared with the no-ASD group were 0.998 (0.78-1.27), 0.98 (0.81-1.18), and 1.22 (1.02-1.47), respectively, while those for ischemic stroke, acute myocardial infarction, and hemorrhagic stroke were 0.96 (0.74-1.24), 0.82 (0.36-1.88), and 1.17 (0.69-1.99), respectively.

Conclusions: ASDs were significantly associated with all-cause mortality in patients with NVAF taking OACs.

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非瓣膜性心房颤动患者服用抑酸药物与临床疗效之间的关系

目的：服用口服抗凝药（OAC）的非瓣膜性心房颤动（NVAF）患者通常会被处方抑酸药（ASD）。然而，服用 OACs 的非瓣膜性心房颤动（NVAF）患者处方 ASDs 的风险收益平衡尚不明确。本研究旨在评估服用 OACs 治疗 NVAF 患者的 ASD 与临床结果之间的关联：本研究是对日本 71 个中心的历史登记研究的子分析。我们纳入了服用维生素 K 拮抗剂治疗 NVAF 的患者，并排除了那些患有机械心脏瓣膜或有肺血栓或深静脉血栓病史的患者。我们于 2013 年 2 月登记了连续的患者，并随访至 2017 年 2 月。主要结果是缺血性事件、大出血和全因死亡率。缺血性中风、急性心肌梗死和出血性中风为次要结果：我们共纳入了 7826 名患者，平均年龄为 73 岁，其中 5274 人（67%）为男性。与无 ASD 组相比，ASD 组缺血性事件、大出血和全因死亡率的调整后危险比（95% 置信区间）分别为 0.998（0.78-1.27）、0.98（0.81-1.18）和 1.22（1.02-1.47），而缺血性卒中、急性心肌梗死和出血性卒中的死亡率分别为0.96（0.74-1.24）、0.82（0.36-1.88）和1.17（0.69-1.99）：结论：在服用 OACs 的 NVAF 患者中，ASD 与全因死亡率密切相关。

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

Drugs in Research & Development Pharmacology, Toxicology and Pharmaceutics-Pharmacology

CiteScore

5.10

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： Drugs in R&D is an international, peer reviewed, open access, online only journal, and provides timely information from all phases of drug research and development that will inform clinical practice. Healthcare decision makers are thus provided with knowledge about the developing place of a drug in therapy. The Journal includes: Clinical research on new and established drugs; Preclinical research of direct relevance to clinical drug development; Short communications and case study reports that meet the above criteria will also be considered; Reviews may also be considered.