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Efficacy and Safety of Proton Pump Inhibitors in Patients With Coronary Artery Diseases Receiving Oral Antiplatelet Agents and/or Anticoagulants: A Systematic Review and Meta-Analysis
The purpose of this meta-analysis was to evaluate the efficacy and safety of proton pump inhibitors (PPIs) plus antithrombotic strategy in patients with coronary artery diseases compared with antithrombotic strategy alone. We searched PubMed, EMBASE, Cochrane Library, and Chinese Biomedical Medical...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Journal of Cardiovascular Pharmacology
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249074/ https://www.ncbi.nlm.nih.gov/pubmed/35512058 http://dx.doi.org/10.1097/FJC.0000000000001284 |
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author | Shang, Yao-Sheng Zhong, Peng-Yu Ma, Ying Bai, Nan Niu, Ying Wang, Zhi-Lu |
author_facet | Shang, Yao-Sheng Zhong, Peng-Yu Ma, Ying Bai, Nan Niu, Ying Wang, Zhi-Lu |
author_sort | Shang, Yao-Sheng |
collection | PubMed |
description | The purpose of this meta-analysis was to evaluate the efficacy and safety of proton pump inhibitors (PPIs) plus antithrombotic strategy in patients with coronary artery diseases compared with antithrombotic strategy alone. We searched PubMed, EMBASE, Cochrane Library, and Chinese Biomedical Medical Literature databases to retrieve randomized controlled trials investigating PPIs combined with antithrombotic strategy in coronary artery diseases. The primary efficacy outcome was major adverse cardiovascular and cerebrovascular events (MACCE). The primary safety outcome was gastrointestinal events. Secondary outcomes included all-cause death, cardiovascular death, myocardial infarction, stent thrombosis, significant bleeding from gastroduodenal lesions, and gastroduodenal ulcer. Overall, 43,943 patients were enrolled from 19 trials. The incidence of MACCE [relative risk (RR) 1.05; 95% confidence interval (CI) 0.96–1.15], all-cause death (RR 0.84; 95% CI 0.69–1.01), cardiovascular death (RR 0.88; 95% CI 0.69–1.12), myocardial infarction (RR 0.98; 95% CI 0.88–1.09), stent thrombosis (RR 1.01; 95% CI 0.76–1.34), and gastroduodenal ulcer (RR 0.40; 95% CI 0.13–1.29) did not increase significantly in patients receiving PPIs compared with patients without those. There were significant differences in the risk of gastrointestinal events (RR 0.34; 95% CI 0.21–0.54) and significant bleeding from gastroduodenal lesions (RR 0.09; 95% CI 0.03–0.28) between the 2 groups. In patients with coronary artery diseases, PPIs plus antithrombotic strategy could reduce the risk of gastrointestinal events and significant bleeding from gastroduodenal lesions but may not affect the incidence of MACCE, all-cause death, cardiovascular death, myocardial infarction, stent thrombosis, and gastroduodenal ulcer (PROSPERO: CRD42021277899, date of registration October 10, 2021). |
format | Online Article Text |
id | pubmed-9249074 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Journal of Cardiovascular Pharmacology |
record_format | MEDLINE/PubMed |
spelling | pubmed-92490742022-07-08 Efficacy and Safety of Proton Pump Inhibitors in Patients With Coronary Artery Diseases Receiving Oral Antiplatelet Agents and/or Anticoagulants: A Systematic Review and Meta-Analysis Shang, Yao-Sheng Zhong, Peng-Yu Ma, Ying Bai, Nan Niu, Ying Wang, Zhi-Lu J Cardiovasc Pharmacol Review Article The purpose of this meta-analysis was to evaluate the efficacy and safety of proton pump inhibitors (PPIs) plus antithrombotic strategy in patients with coronary artery diseases compared with antithrombotic strategy alone. We searched PubMed, EMBASE, Cochrane Library, and Chinese Biomedical Medical Literature databases to retrieve randomized controlled trials investigating PPIs combined with antithrombotic strategy in coronary artery diseases. The primary efficacy outcome was major adverse cardiovascular and cerebrovascular events (MACCE). The primary safety outcome was gastrointestinal events. Secondary outcomes included all-cause death, cardiovascular death, myocardial infarction, stent thrombosis, significant bleeding from gastroduodenal lesions, and gastroduodenal ulcer. Overall, 43,943 patients were enrolled from 19 trials. The incidence of MACCE [relative risk (RR) 1.05; 95% confidence interval (CI) 0.96–1.15], all-cause death (RR 0.84; 95% CI 0.69–1.01), cardiovascular death (RR 0.88; 95% CI 0.69–1.12), myocardial infarction (RR 0.98; 95% CI 0.88–1.09), stent thrombosis (RR 1.01; 95% CI 0.76–1.34), and gastroduodenal ulcer (RR 0.40; 95% CI 0.13–1.29) did not increase significantly in patients receiving PPIs compared with patients without those. There were significant differences in the risk of gastrointestinal events (RR 0.34; 95% CI 0.21–0.54) and significant bleeding from gastroduodenal lesions (RR 0.09; 95% CI 0.03–0.28) between the 2 groups. In patients with coronary artery diseases, PPIs plus antithrombotic strategy could reduce the risk of gastrointestinal events and significant bleeding from gastroduodenal lesions but may not affect the incidence of MACCE, all-cause death, cardiovascular death, myocardial infarction, stent thrombosis, and gastroduodenal ulcer (PROSPERO: CRD42021277899, date of registration October 10, 2021). Journal of Cardiovascular Pharmacology 2022-07 2022-05-04 /pmc/articles/PMC9249074/ /pubmed/35512058 http://dx.doi.org/10.1097/FJC.0000000000001284 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Review Article Shang, Yao-Sheng Zhong, Peng-Yu Ma, Ying Bai, Nan Niu, Ying Wang, Zhi-Lu Efficacy and Safety of Proton Pump Inhibitors in Patients With Coronary Artery Diseases Receiving Oral Antiplatelet Agents and/or Anticoagulants: A Systematic Review and Meta-Analysis |
title | Efficacy and Safety of Proton Pump Inhibitors in Patients With Coronary Artery Diseases Receiving Oral Antiplatelet Agents and/or Anticoagulants: A Systematic Review and Meta-Analysis |
title_full | Efficacy and Safety of Proton Pump Inhibitors in Patients With Coronary Artery Diseases Receiving Oral Antiplatelet Agents and/or Anticoagulants: A Systematic Review and Meta-Analysis |
title_fullStr | Efficacy and Safety of Proton Pump Inhibitors in Patients With Coronary Artery Diseases Receiving Oral Antiplatelet Agents and/or Anticoagulants: A Systematic Review and Meta-Analysis |
title_full_unstemmed | Efficacy and Safety of Proton Pump Inhibitors in Patients With Coronary Artery Diseases Receiving Oral Antiplatelet Agents and/or Anticoagulants: A Systematic Review and Meta-Analysis |
title_short | Efficacy and Safety of Proton Pump Inhibitors in Patients With Coronary Artery Diseases Receiving Oral Antiplatelet Agents and/or Anticoagulants: A Systematic Review and Meta-Analysis |
title_sort | efficacy and safety of proton pump inhibitors in patients with coronary artery diseases receiving oral antiplatelet agents and/or anticoagulants: a systematic review and meta-analysis |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249074/ https://www.ncbi.nlm.nih.gov/pubmed/35512058 http://dx.doi.org/10.1097/FJC.0000000000001284 |
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