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The long-term risk for myocardial infarction or stroke after proton pump inhibitor therapy (2008-2018).
Aliment. Pharmacol. Ther. 54, 1033-1040 (2021)
Background: Proton pump inhibitors (PPIs) are well tolerated in the short term but have recently been associated with increased long-term cardiovascular risk in observational studies. Aims: To evaluate long-term risks of myocardial infarction (MI) and ischaemic stroke (IS) associated with PPI vs H2-receptor antagonist (H2RA) therapy in adults without pre-existing cardiovascular or cerebrovascular disease. Methods: Using administrative claims data (2008–2018), we emulated a target trial comparing MI and IS risks in new users of PPIs vs H2RAs. Treatment was identified using dispensed prescriptions. MI and IS were defined using hospital discharge codes. Inverse probability weighting was used to adjust for confounding, and Cox models to estimate hazard ratios (HRs). Survival curves were estimated using weighted Kaplan-Meier estimators. Results: We identified 1 143 948 new users of PPIs and 36 229 new users of H2RAs who were free of prevalent cardiovascular or cerebrovascular disease. The mean follow-up time was 6.2 years for PPI initiators and 5.3 years for H2RA initiators. After 10 years, the HRs for MI and IS were 0.96 (95% confidence interval (CI): 0.80-1.16) and 0.98 (95% CI: 0.89-1.08), respectively. Conclusions: This analysis of claims data of a large German health insurer did not provide evidence that PPI therapy increased the risk of MI or IS in the first decade after treatment initiation.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Cardiovascular Events; Inverse Probability; Survival; Adults; Association
ISSN (print) / ISBN
0269-2813
e-ISSN
1365-2036
Quellenangaben
Volume: 54,
Issue: 8,
Pages: 1033-1040
Publisher
Blackwell Scientific Publications
Publishing Place
111 River St, Hoboken 07030-5774, Nj Usa
Non-patent literature
Publications
Reviewing status
Peer reviewed
Institute(s)
Institute of Epidemiology II (EPI2)
Independent Research Group Clinical Epidemiology (KEPI)
Independent Research Group Clinical Epidemiology (KEPI)
Grants
Innovation Committee at the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA)
Innovation Committee at the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA)