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: a five-year experience from a single-centre observational registry

Niels P. G. Hoedemaker*, Peter Damman, Jan Paul Ottervanger, Jan Henk E. Dambrink, A. T. Marcel Gosselink, Elvin Kedhi, Evelien Kolkman, Robbert J. de Winter, Arnoud W. J. van't Hof*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Web of Science)

Abstract

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, P

Conclusion 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.

Original languageEnglish
Pages (from-to)127-138
Number of pages12
JournalEuropean Heart Journal-Cardiovascular Pharmacotherapy
Volume5
Issue number3
DOIs
Publication statusPublished - Jul 2019

Keywords

  • Proton-pump inhibitors
  • Acute coronary syndrome
  • Dual antiplatelet therapy
  • Registry
  • Outcomes
  • ACUTE MYOCARDIAL-INFARCTION
  • ST-SEGMENT ELEVATION
  • DUAL-ANTIPLATELET THERAPY
  • BASE-LINE CHARACTERISTICS
  • PLATELET INHIBITION
  • CLINICAL-OUTCOMES
  • CONCOMITANT USE
  • EUROPEAN-SOCIETY
  • TASK-FORCE
  • 2017 ESC

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