Meta-Analysis of Efficacy and Safety of Proton Pump Inhibitors with Dual Antiplatelet Therapy for Coronary Artery Disease.
Aged
Aged, 80 and over
Coronary Artery Disease
/ drug therapy
Drug Therapy, Combination
Female
Gastrointestinal Hemorrhage
/ chemically induced
Humans
Male
Middle Aged
Observational Studies as Topic
Platelet Aggregation Inhibitors
/ administration & dosage
Proton Pump Inhibitors
/ administration & dosage
Randomized Controlled Trials as Topic
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Coronary artery disease
Dual antiplatelet therapy
Meta- analysis
Proton pump inhibitors
Journal
Cardiovascular revascularization medicine : including molecular interventions
ISSN: 1878-0938
Titre abrégé: Cardiovasc Revasc Med
Pays: United States
ID NLM: 101238551
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
20
11
2018
revised:
16
01
2019
accepted:
05
02
2019
pubmed:
19
2
2019
medline:
28
7
2020
entrez:
19
2
2019
Statut:
ppublish
Résumé
There is inconsistency in the literature regarding the clinical effects of proton pump inhibitors (PPI) when added to dual antiplatelet therapy (DAPT) in subjects with coronary artery disease (CAD). We performed meta-analysis stratified by study design to explore these differences. 39 studies [4 randomized controlled trials (RCTs) and 35 observational studies) were selected using MEDLINE, EMBASE and CENTRAL (Inception-January 2018). In 221,204 patients (PPI = 77,731 patients, no PPI =143,473 patients), RCTs restricted analysis showed that PPI did not increase the risk of all-cause mortality (Risk Ratio (RR): 1.35, 95% Confidence Interval (CI), 0.56-3.23, P = 0.50, I Meta-analysis of RCTs endorsed the use of PPI with DAPT for reducing GI bleeding without worsening cardiovascular outcomes. These findings oppose the negative observational data regarding effects of PPI with DAPT.
Sections du résumé
BACKGROUND
BACKGROUND
There is inconsistency in the literature regarding the clinical effects of proton pump inhibitors (PPI) when added to dual antiplatelet therapy (DAPT) in subjects with coronary artery disease (CAD). We performed meta-analysis stratified by study design to explore these differences.
METHODS AND RESULTS
RESULTS
39 studies [4 randomized controlled trials (RCTs) and 35 observational studies) were selected using MEDLINE, EMBASE and CENTRAL (Inception-January 2018). In 221,204 patients (PPI = 77,731 patients, no PPI =143,473 patients), RCTs restricted analysis showed that PPI did not increase the risk of all-cause mortality (Risk Ratio (RR): 1.35, 95% Confidence Interval (CI), 0.56-3.23, P = 0.50, I
CONCLUSION
CONCLUSIONS
Meta-analysis of RCTs endorsed the use of PPI with DAPT for reducing GI bleeding without worsening cardiovascular outcomes. These findings oppose the negative observational data regarding effects of PPI with DAPT.
Identifiants
pubmed: 30773427
pii: S1553-8389(19)30107-1
doi: 10.1016/j.carrev.2019.02.002
pmc: PMC7489463
mid: NIHMS1620969
pii:
doi:
Substances chimiques
Platelet Aggregation Inhibitors
0
Proton Pump Inhibitors
0
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1125-1133Subventions
Organisme : NIGMS NIH HHS
ID : U54 GM104942
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.
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