Proton-pump inhibitor use by coronary artery disease patients is associated with fewer chest pain episodes, emergency department visits and hospitalizations.
BACKGROUND
Patients with coronary artery disease presenting to an emergency department with chest pain are likely to undergo hospitalization in an attempt to elucidate its aetiology.


OBJECTIVE
To examine whether coronary artery disease patients receiving proton-pump inhibitor therapy are associated with fewer chest pain events and evaluations.


METHODS
A veteran patient population with documented coronary artery disease was identified, and chest pain episodes, emergency department visits and hospitalizations for chest pain were followed over 2 years. Patient outcomes between proton-pump inhibitor use and non-use of proton-pump inhibitor therapy were compared.


RESULTS
In 415 male patients, 23% utilized a proton-pump inhibitor and 77% did not. Proton-pump inhibitor therapy was associated with fewer chest pain episodes (12% vs. 26%, P = 0.002), emergency department visits, (12% vs. 24%, P = 0.044) and hospitalizations (13% vs. 24%, P = 0.086). The incidence of adverse events was decreased in the proton-pump inhibitor group: 70% fewer chest pain episodes (P = 0.002, RR = 3.3), 55% fewer emergency department visits (P = 0.049, RR = 2.2) and 53% fewer hospitalizations (P = 0.064, RR = 2.1). By multivariate analysis, proton-pump inhibitor therapy independently predicted a reduced prevalence of patients experiencing chest pain, emergency department visits, and hospitalizations [OR = 0.09 (0.04-0.21); 0.15 (0.06-0.40); 0.14 (0.05-0.40); all P < 0.001].


CONCLUSIONS
Proton-pump inhibitor therapy for veteran coronary artery disease patients is associated with fewer chest pain episodes, emergency department visits and hospitalizations for chest pain.
Liuzzo
J P
JP
Department of Medicine, Division of Cardiology, Saint Vincent Catholic Medical Centers, New York, NY and New York Medical College, Valhalla, New York, NY, USA. jliu2006@yahoo.com
Ambrose
J A
JA
Diggs
P
P
D000368:Aged; D002637:Chest Pain / Q000517:prevention & control*; D003324:Coronary Artery Disease / Q000188:drug therapy*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004638:Emergency Treatment; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D054328:Proton Pump Inhibitors; D016896:Treatment Outcome
D054328:Proton Pump Inhibitors