title: Connections between nutritional status and proton pump inhibitor therapy in patients scheduled for cardiovascular rehabilitation after treatment for ischaemic and valvular heart disease.
abstract: BACKGROUND
  Multiple and yet uncertain connections exist between cardiovascular diseases and the nutritional status of patients, particularly in relation to cardiovascular treatments. Proton pump inhibitors (PPI) are among the most commonly used group of drugs.
  
  
  OBJECTIVE
  To analyse utilisation of PPI in association with nutritional risk of patients scheduled for rehabilitation after treatment for ischaemic and valvular heart disease.
  
  
  METHODS
  Retrospective analyses on a consecutive sample of patients, which included drug utilisation of PPI and nutritional risk screening, using a standardised NRS-2002 tool. The patients (n = 536) were divided into groups based on previous cardiovascular treatments and use of PPI.
  
  
  RESULTS
  Nearly half of the patients (244, 46.1%) had PPI in their chronic therapy despite the clinically negligible prevalence of conditions that are their fundamental indications. The odds for using PPI in patients with increased nutritional risk, estimated by logistic regression, were 3.34 (95% confidence intervals [CI] 2.26-4.94), p < 0.001. Receiver operating curve analyses also revealed significant differences of PPI utilisation in connection with NRS-2002 > 3: positive likelihood-ratio (LR) 2.35 (95% CI 2.10-2.60); negative LR 0.46 (95% CI 0.4-0.6); area under the curve (AUC) 0.720; p < 0.001; as well as the percentage weigh loss history > 6.36% (positive LR 2.22 [95% CI 2.00-2.50]; negative LR 0.41 [95% CI 0.30-0.50]; AUC 0.707; p < 0.001).
  
  
  CONCLUSIONS
  Utilisation of PPI was found to be of relatively high prevalence and significantly associated with parameters of nutritional risk screening. Furthermore, it was in correlation with the age of patients and the existence of chronic kidney disease, which are well-established predispositions for poor nutritional status. Nutritional risk seems to be additionally negatively challenged by utilisation of PPI due to gastric malabsorption and anaemia.
authors.affiliation: Department of Cardiology, University Hospital "Thalassotherapia Opatija", Medical Faculty University of Rijeka, Croatia Department of Internal Medicine, University Hospital Osijek, Medical Faculty JJ Strossmayer University of Osijek, Croatia. marcoboban@yahoo.com.
authors.forename: Marko
authors.initials: M
authors.lastname: Boban
authors.forename: Viktor
authors.initials: V
authors.lastname: Persic
authors.forename: Mate
authors.initials: M
authors.lastname: Petricevic
authors.forename: Bojan
authors.initials: B
authors.lastname: Biocina
authors.forename: Tomislav
authors.initials: T
authors.lastname: Sipic
authors.forename: Vesna
authors.initials: V
authors.lastname: Pehar-Pejcnovic
authors.forename: Sanja
authors.initials: S
authors.lastname: Balen
authors.forename: Marinko
authors.initials: M
authors.lastname: Zulj
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Vcev
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000072038:Cardiac Rehabilitation; D005260:Female; D006349:Heart Valve Diseases / Q000188:drug therapy* / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D051436:Renal Insufficiency, Chronic; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D054328:Proton Pump Inhibitors
keywords: ischaemic heart disease; nutritional risk; nutritional status; proton pump inhibitors (PPI); valvular heart disease