Document Detail


Revising the link between proton-pump inhibitors and risk of acute myocardial infarction-a case-crossover analysis.
MedLine Citation:
PMID:  25384436     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: The purpose of this study is to investigate if the prescription of proton-pump inhibitors (PPIs) was associated with a sudden risk of acute myocardial infarction (AMI) while controlling for time-invariant confounding by using a case-crossover design. An association might indicate that physicians take prodromal symptoms of myocardial ischaemia for dyspepsia.
METHODS: We applied a case-crossover design to investigate all AMI patients admitted to the hospital in the Skåne region, Sweden, between Oct 14, 2005 and Dec 31, 2006 and their PPI prescriptions and dispensations 3 months prior to the AMI onset. We retrieved the information about prescribed medication from the Swedish Drug Register containing individual information on all dispensed drugs prescribed in the outpatient care and dispensed in any of the Swedish pharmacies. Additionally, we stratified the analyses by history of AMI.
RESULTS: We identified 3490 AMI cases aged 40 to 90; 61 % were men. The odds ratio for AMI onset in those with a prescription of PPIs during a hazard period of 3 days compared to control periods was 1.36 (95 % confidence interval (CI) 0.82-2.25) in the whole study cohort and 1.66 (95 % CI 1.00-2.76) in those without history of AMI. The corresponding odds ratio (OR) based on the dispensation date (suggesting use of the drug) was 1.26 (95 % CI 0.92-1.72) and 1.29 (95 % CI 0.92-1.83), respectively.
CONCLUSIONS: In our opinion, the previously reported increase in risk of adverse cardiac events in patients using PPIs may reflect the fact that an AMI may be misinterpreted as dyspepsia.
Authors:
Aleksandra Turkiewicz; Raquel Perez Vicente; Henrik Ohlsson; Patrik Tyden; Juan Merlo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-12
Journal Detail:
Title:  European journal of clinical pharmacology     Volume:  -     ISSN:  1432-1041     ISO Abbreviation:  Eur. J. Clin. Pharmacol.     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-11     Completed Date:  -     Revised Date:  2014-11-12    
Medline Journal Info:
Nlm Unique ID:  1256165     Medline TA:  Eur J Clin Pharmacol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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