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Proton Pump Inhibitors Raise the Risk of CVD and Mortality in T2D
- In patients with type 2 diabetes (T2D), proton pump inhibitor use was associated with an increased risk of cardiovascular disease (CVD), such as coronary artery disease, myocardial infarction and heart failure, and all-cause mortality.
- There was no significant association between the proton pump inhibitor use and stroke risk.
Why This Matters
- Findings suggest that clinicians should consider benefit-risk assessments before prescribing proton pump inhibitors to patients with T2D.
- This was a large prospective cohort study that included 19,229 patients (age, 37-73 years) with T2D from the UK Biobank (2006-2010).
- Primary outcomes: coronary artery disease, myocardial infarction, stroke, and heart failure.
- Secondary outcome: all-cause mortality.
- Funding: None disclosed.
- During a median follow-up of 10.9-11.2 years, 2971 cases of coronary artery disease, 1827 cases of myocardial infarction, 1192 cases of heart failure, 738 cases of stroke and 2297 deaths were reported.
- Proton pump inhibitor users vs non-users had higher risks of (adjusted HR [aHR]; 95% CI):
- coronary artery disease (1.27; 1.15 to 1.40);
- myocardial infarction (1.34; 1.18 to 1.52);
- heart failure (1.35; 1.16 to 1.57); and
- all-cause mortality (1.30; 1.16 to 1.45).
- No significant association was seen between proton pump inhibitor use and stroke risk (aHR 1.11; 95% CI 0.90 to 1.36).
- These results were consistent in the subgroup analyses stratified by indications for proton pump inhibitors, anti-diabetic medication use and antiplatelet drug use.
- Observational design.
- Data on proton pump inhibitor use were self-reported.