title: Proton pump inhibitor use and risk of adverse cardiovascular events in aspirin treated patients with first time myocardial infarction: nationwide propensity score matched study.
abstract: OBJECTIVE
  To examine the effect of proton pump inhibitors on adverse cardiovascular events in aspirin treated patients with first time myocardial infarction.
  
  
  METHODS
  Retrospective nationwide propensity score matched study based on administrative data. Setting All hospitals in Denmark.
  
  
  METHODS
  All aspirin treated patients surviving 30 days after a first myocardial infarction from 1997 to 2006, with follow-up for one year. Patients treated with clopidogrel were excluded.
  
  
  METHODS
  The risk of the combined end point of cardiovascular death, myocardial infarction, or stroke associated with use of proton pump inhibitors was analysed using Kaplan-Meier analysis, Cox proportional hazard models, and propensity score matched Cox proportional hazard models. Results 3366 of 19,925 (16.9%) aspirin treated patients experienced recurrent myocardial infarction, stroke, or cardiovascular death. The hazard ratio for the combined end point in patients receiving proton pump inhibitors based on the time dependent Cox proportional hazard model was 1.46 (1.33 to 1.61; P<0.001) and for the propensity score matched model based on 8318 patients it was 1.61 (1.45 to 1.79; P<0.001). A sensitivity analysis showed no increase in risk related to use of H(2) receptor blockers (1.04, 0.79 to 1.38; P=0.78). Conclusion In aspirin treated patients with first time myocardial infarction, treatment with proton pump inhibitors was associated with an increased risk of adverse cardiovascular events.
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Post 635, Niels Andersens Vej 65, 2900 Hellerup, Denmark. mc@heart.dk
authors.forename: Mette
authors.initials: M
authors.lastname: Charlot
authors.forename: Erik L
authors.initials: EL
authors.lastname: Grove
authors.forename: Peter Riis
authors.initials: PR
authors.lastname: Hansen
authors.forename: Jonas B
authors.initials: JB
authors.lastname: Olesen
authors.forename: Ole
authors.initials: O
authors.lastname: Ahlehoff
authors.forename: Christian
authors.initials: C
authors.lastname: Selmer
authors.forename: Jesper
authors.initials: J
authors.lastname: Lindhardsen
authors.forename: Jan Kyst
authors.initials: JK
authors.lastname: Madsen
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Gislason
mesh_terms: D000328:Adult; D000368:Aged; D001241:Aspirin / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000401:mortality; D003718:Denmark; D004347:Drug Interactions; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D011379:Prognosis; D057216:Propensity Score; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000139:chemically induced
chemical_list: D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors; D001241:Aspirin