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Use of proton pump inhibitor may be associated with progression of cerebral small vessel disease

Proton pump inhibitors (PPIs) are widely used for the treatment of gastrointestinal diseases. However, recent studies have shown that chronic PPI use is associated with the progression of endothelial senescence and cerebrovascular diseases. We hypothesized that PPI users might be vulnerable to fast...

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Autores principales: Kang, Min Kyoung, Shin, Jung Hwan, Kim, Tae Jung, Lee, Ji Sung, Yoon, Byung-Woo, Ko, Sang-Bae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9770424/
https://www.ncbi.nlm.nih.gov/pubmed/36542643
http://dx.doi.org/10.1371/journal.pone.0279257
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author Kang, Min Kyoung
Shin, Jung Hwan
Kim, Tae Jung
Lee, Ji Sung
Yoon, Byung-Woo
Ko, Sang-Bae
author_facet Kang, Min Kyoung
Shin, Jung Hwan
Kim, Tae Jung
Lee, Ji Sung
Yoon, Byung-Woo
Ko, Sang-Bae
author_sort Kang, Min Kyoung
collection PubMed
description Proton pump inhibitors (PPIs) are widely used for the treatment of gastrointestinal diseases. However, recent studies have shown that chronic PPI use is associated with the progression of endothelial senescence and cerebrovascular diseases. We hypothesized that PPI users might be vulnerable to fast progression of cerebral small vessel disease (SVD) with cumulative effects. Four hundred and eleven patients, who underwent brain magnetic resonance imaging, more than twice between January 2010 and December 2016 were screened. Patients aged < 50 years, and those who had concomitant diseases that might affect the progression of cerebral SVD were excluded. Baseline characteristics were collected. We evaluated the severity of SVD using the Fazekas score, the number of cerebral microbleeds (CMBs), and assessed the progression of SVD or CMBs based on the cumulative dose of PPIs. Among the included patients (N = 137), 39 were PPI ever-users. Univariate Cox regression analysis showed that PPI use was independently associated with the progression of Fazekas score only in the deep white matter hyperintensities (WMH) (hazard ratio [HR] 2.891, 95% confidence interval [CI] 1.210–6.906, P = 0.017). In multivariate Cox regression analysis, long-term PPI use was associated with a progression of Fazekas score in the deep WMH (HR 3.453, 95% CI 1.027–9.475, P = 0.045). However, PPI use was not associated with the progression of CMB. The present study results suggest that long-term use of PPIs is associated with the progression of deep cerebral WMH. Further research is needed using a large number of patients to validate this relationship.
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spelling pubmed-97704242022-12-22 Use of proton pump inhibitor may be associated with progression of cerebral small vessel disease Kang, Min Kyoung Shin, Jung Hwan Kim, Tae Jung Lee, Ji Sung Yoon, Byung-Woo Ko, Sang-Bae PLoS One Research Article Proton pump inhibitors (PPIs) are widely used for the treatment of gastrointestinal diseases. However, recent studies have shown that chronic PPI use is associated with the progression of endothelial senescence and cerebrovascular diseases. We hypothesized that PPI users might be vulnerable to fast progression of cerebral small vessel disease (SVD) with cumulative effects. Four hundred and eleven patients, who underwent brain magnetic resonance imaging, more than twice between January 2010 and December 2016 were screened. Patients aged < 50 years, and those who had concomitant diseases that might affect the progression of cerebral SVD were excluded. Baseline characteristics were collected. We evaluated the severity of SVD using the Fazekas score, the number of cerebral microbleeds (CMBs), and assessed the progression of SVD or CMBs based on the cumulative dose of PPIs. Among the included patients (N = 137), 39 were PPI ever-users. Univariate Cox regression analysis showed that PPI use was independently associated with the progression of Fazekas score only in the deep white matter hyperintensities (WMH) (hazard ratio [HR] 2.891, 95% confidence interval [CI] 1.210–6.906, P = 0.017). In multivariate Cox regression analysis, long-term PPI use was associated with a progression of Fazekas score in the deep WMH (HR 3.453, 95% CI 1.027–9.475, P = 0.045). However, PPI use was not associated with the progression of CMB. The present study results suggest that long-term use of PPIs is associated with the progression of deep cerebral WMH. Further research is needed using a large number of patients to validate this relationship. Public Library of Science 2022-12-21 /pmc/articles/PMC9770424/ /pubmed/36542643 http://dx.doi.org/10.1371/journal.pone.0279257 Text en © 2022 Kang et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kang, Min Kyoung
Shin, Jung Hwan
Kim, Tae Jung
Lee, Ji Sung
Yoon, Byung-Woo
Ko, Sang-Bae
Use of proton pump inhibitor may be associated with progression of cerebral small vessel disease
title Use of proton pump inhibitor may be associated with progression of cerebral small vessel disease
title_full Use of proton pump inhibitor may be associated with progression of cerebral small vessel disease
title_fullStr Use of proton pump inhibitor may be associated with progression of cerebral small vessel disease
title_full_unstemmed Use of proton pump inhibitor may be associated with progression of cerebral small vessel disease
title_short Use of proton pump inhibitor may be associated with progression of cerebral small vessel disease
title_sort use of proton pump inhibitor may be associated with progression of cerebral small vessel disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9770424/
https://www.ncbi.nlm.nih.gov/pubmed/36542643
http://dx.doi.org/10.1371/journal.pone.0279257
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