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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...

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Autores principales: Shang, Yao-Sheng, Zhong, Peng-Yu, Ma, Ying, Bai, Nan, Niu, Ying, Wang, Zhi-Lu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Journal of Cardiovascular Pharmacology 2022
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).
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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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