title: Proton pump inhibitor use is not associated with cardiac arrhythmia in critically ill patients.
abstract: Hypomagnesemia can lead to cardiac arrythmias. Recently, observational data have linked chronic proton pump inhibitor (PPI) exposure to hypomagnesemia. Whether PPI exposure increases the risk for arrhythmias has not been well studied. Using a large, single-center inception cohort of critically ill patients, we examined whether PPI exposure was associated with admission electrocardiogram readings of a cardiac arrhythmia in more than 8000 patients. There were 25.4% PPI users, whereas 6% were taking a histamine 2 antagonist. In all, 14.0% had a cardiac arrhythmia. PPI use was associated with an unadjusted risk of arrhythmia of 1.15 (95% CI,1.00-1.32; P =.04) and an adjusted risk of arrhythmia of 0.91 (95% CI, 0.77-1.06; P =.22). Among diuretic users (n = 2476), PPI use was similarly not associated with an increased risk of cardiac arrhythmia. In summary, in a large cohort of critically ill patients, PPI exposure is not associated with an increased risk of cardiac arrhythmia.
authors: Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors: Kenneth P
authors: KP
authors: Chen
authors: School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.|Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.
authors: Joon
authors: J
authors: Lee
authors: Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.
authors: Roger G
authors: RG
authors: Mark
authors: Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.
authors: Mengling
authors: M
authors: Feng
authors: Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.|Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.
authors: Leo A
authors: LA
authors: Celi
authors: Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
authors: Brian E
authors: BE
authors: Malley
authors: Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors: John
authors: J
authors: Danziger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000453:epidemiology; D016638:Critical Illness; D004232:Diuretics / Q000008:administration & dosage; D004562:Electrocardiography; D005260:Female; D006635:Histamine H2 Antagonists / Q000009:adverse effects*; D006801:Humans; D008274:Magnesium / Q000097:blood*; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D012189:Retrospective Studies; D012306:Risk
chemical_list: D004232:Diuretics; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D008274:Magnesium
keywords: arrhythmia; hypomagnesemia; proton pump inhibitor
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