Do Proton Pump Inhibitors Increase the Risk for CVD in Patients with Type 2 Diabetes?
BACKGROUND AND PURPOSE:
- Proton pump inhibitors (PPIs), used for treating gastric-acid related diseases, have been linked with cardiovascular disease (CVD)
- How PPI use affects type 2 diabetes (T2D) patients, who are more likely to use PPIs and more likely to develop CVD, is unclear
- Geng et al. (Journal of Clinical Endocrinology & Metabolism, 2022) evaluate the associations of PPI use with risks of CVD and all-cause mortality in patients with T2D
METHODS:
- Secondary analysis of prospective cohort study
- Population
- Patients in the UK Biobank with preexisting T2D
- Exposure
- PPI use
- Primary outcomes
- Coronary artery disease (CAD)
- Myocardial infarction (MI)
- Heart failure (HF)
- Stroke
- All-cause mortality
RESULTS:
- 19,229 adults with T2D
- Median follow up: 10.9 to 11.2 years
- PPI use was significantly associated with higher risks of
- CAD: HR 1.27 (95% CI, 1.15 to 1.40)
- MI: HR 1.34 (95% CI, 1.18 to 1.52)
- HF: HR 1.35 (95% CI, 1.16 to 1.57)
- All-cause mortality: HR 1.30 (95% CI, 1.16 to 1.45)
- The results were consistent in the subgroup analyses stratified by factors including
- Indications of PPI | Antidiabetic medication use | Antiplatelet drug use
- Analyses in a 1:1 propensity score-matched cohort of PPI users vs nonusers yielded similar results
CONCLUSION:
- PPI use among patients with T2D is associated with an increased risk of CVD events, compared to non-use
- The authors state
The benefits and risks of PPI use should be carefully balanced among patients with T2D, and monitoring of adverse CVD events during PPI therapy should be enhanced
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