TY - JOUR
T1 - Trends in cardiovascular and bleeding outcomes in acute coronary syndrome patients treated with or without proton-pump inhibitors during the introduction of novel P2Y12 inhibitors
T2 - a five-year experience from a single-centre observational registry
AU - Hoedemaker, Niels P. G.
AU - Damman, Peter
AU - Ottervanger, Jan Paul
AU - Dambrink, Jan Henk E.
AU - Gosselink, A. T. Marcel
AU - Kedhi, Elvin
AU - Kolkman, Evelien
AU - de Winter, Robbert J.
AU - van't Hof, Arnoud W. J.
PY - 2019/7
Y1 - 2019/7
N2 - Aims Proton-pump inhibitors (PPIs) are commonly prescribed in acute coronary syndrome (ACS) patients on antiplatelet therapy. We studied PPI prescription in ACS patients in the era of novel P2Y12 inhibitors and assessed the association between PPI use and clinical outcomes.Methods and results Between 2010 and 2014, we included all consecutive ACS patients admitted to a Dutch tertiary hospital. The main outcome was PPI prescription at discharge. Additionally, we present 1-year mortality and 30-day cardiovascular and bleeding outcomes. Of 4595 ACS patients with known discharge medication, 63.9% received a PPI. PPI-treated patients were older (67.112.5 vs. 63.0 +/- 13.3, PConclusion In this single-centre registry, PPI prescription in ACS patients doubled between 2010 and 2014. PPI treatment at discharge was associated with a reduction in death, MI, or stroke at 30-days post-discharge, mainly driven by a reduction in MI. There were no differences gastrointestinal bleeding between patients treated with or without a PPI. PPI treatment may serve as a marker of improved therapies and outcome, rather than causing a reduction in cardiovascular events.
AB - Aims Proton-pump inhibitors (PPIs) are commonly prescribed in acute coronary syndrome (ACS) patients on antiplatelet therapy. We studied PPI prescription in ACS patients in the era of novel P2Y12 inhibitors and assessed the association between PPI use and clinical outcomes.Methods and results Between 2010 and 2014, we included all consecutive ACS patients admitted to a Dutch tertiary hospital. The main outcome was PPI prescription at discharge. Additionally, we present 1-year mortality and 30-day cardiovascular and bleeding outcomes. Of 4595 ACS patients with known discharge medication, 63.9% received a PPI. PPI-treated patients were older (67.112.5 vs. 63.0 +/- 13.3, PConclusion In this single-centre registry, PPI prescription in ACS patients doubled between 2010 and 2014. PPI treatment at discharge was associated with a reduction in death, MI, or stroke at 30-days post-discharge, mainly driven by a reduction in MI. There were no differences gastrointestinal bleeding between patients treated with or without a PPI. PPI treatment may serve as a marker of improved therapies and outcome, rather than causing a reduction in cardiovascular events.
KW - Proton-pump inhibitors
KW - Acute coronary syndrome
KW - Dual antiplatelet therapy
KW - Registry
KW - Outcomes
KW - ACUTE MYOCARDIAL-INFARCTION
KW - ST-SEGMENT ELEVATION
KW - DUAL-ANTIPLATELET THERAPY
KW - BASE-LINE CHARACTERISTICS
KW - PLATELET INHIBITION
KW - CLINICAL-OUTCOMES
KW - CONCOMITANT USE
KW - EUROPEAN-SOCIETY
KW - TASK-FORCE
KW - 2017 ESC
U2 - 10.1093/ehjcvp/pvy030
DO - 10.1093/ehjcvp/pvy030
M3 - Article
VL - 5
SP - 127
EP - 138
JO - European Heart Journal-Cardiovascular Pharmacotherapy
JF - European Heart Journal-Cardiovascular Pharmacotherapy
SN - 2055-6837
IS - 3
ER -