Association Between Clinical Use of Lansoprazole and the Risk of Coronary Heart Disease: A Nationwide Pharmacoepidemiological Cohort Study.

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiovascular Drugs and Therapy Pub Date : 2024-12-13 DOI:10.1007/s10557-024-07643-4

Ming-Hsun Lin, Wen-Tung Wu, Yong-Chen Chen, Wu-Chien Chien, Tsung-Kun Lin, Yu-Ching Chou, Po-Shun Hsu, Chien-An Sun

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Abstract

Purpose: Proton pump inhibitors (PPIs) are widely prescribed for gastrointestinal disorders. Lansoprazole, a PPI, has been recognized for its potential effects of improving insulin resistance, reduction of oxidative stress, and improvement in atherosclerosis through peroxisome proliferator-activated receptor gamma (PPARγ) induction. This study aims to investigate whether lansoprazole poses a distinct risk of coronary heart disease (CHD) compared to other PPIs.

Methods: A retrospective cohort study utilized data from the National Health Insurance Research Database in Taiwan spanning from 2000 to 2013. The exposed cohort included 1666 patients with lansoprazole use, while the comparison cohort comprised 6664 patients using other PPIs. The primary outcome was incident CHD. Cox regression models were employed to assess the association between lansoprazole use and CHD risk, presenting hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: Patients prescribed lansoprazole demonstrated a significantly reduced risk of CHD compared to those undergoing other PPI treatments in individuals without a history of CHD. Lansoprazole users exhibited a 25% lower risk of developing CHD compared to other PPI users (adjusted HR 0.75; 95% CI 0.65-0.87). Intriguingly, this inverse association between lansoprazole use and CHD risk was consistent across genders and various age groups.

Conclusion: This study suggests that lansoprazole is associated with a decreased risk of CHD in comparison to other PPIs in patients without a history of CHD. Further research is warranted to elucidate the clinical implications of these findings.

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临床使用兰索拉唑与冠心病风险之间的关系：全国药物流行病学队列研究》。

目的：质子泵抑制剂（PPIs）被广泛用于胃肠道疾病。兰索拉唑是一种PPI，已被认为具有改善胰岛素抵抗、减少氧化应激和通过诱导过氧化物酶体增殖物激活受体γ (PPARγ)改善动脉粥样硬化的潜在作用。本研究旨在探讨兰索拉唑与其他PPIs相比是否具有明显的冠心病（CHD）风险。暴露队列包括1666名使用兰索拉唑的患者，而比较队列包括6664名使用其他PPIs的患者。主要结局为偶发性冠心病。采用Cox回归模型评估兰索拉唑使用与冠心病风险之间的关系，给出风险比（hr）和95%置信区间（ci）。结果：与没有冠心病史的患者相比，服用兰索拉唑的患者患冠心病的风险显著降低。与其他PPI使用者相比，兰索拉唑使用者患冠心病的风险降低25%(调整后HR 0.75；95% ci 0.65-0.87)。有趣的是，使用兰索拉唑与冠心病风险之间的负相关在性别和不同年龄组中是一致的。结论：本研究表明，与其他PPIs相比，兰索拉唑与无冠心病史患者冠心病风险降低有关。需要进一步的研究来阐明这些发现的临床意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Drugs and Therapy 医学-心血管系统

CiteScore

8.30

自引率

0.00%

发文量

110

审稿时长

4.5 months

期刊介绍： Designed to objectively cover the process of bench to bedside development of cardiovascular drug, device and cell therapy, and to bring you the information you need most in a timely and useful format, Cardiovascular Drugs and Therapy takes a fresh and energetic look at advances in this dynamic field. Homing in on the most exciting work being done on new therapeutic agents, Cardiovascular Drugs and Therapy focusses on developments in atherosclerosis, hyperlipidemia, diabetes, ischemic syndromes and arrhythmias. The Journal is an authoritative source of current and relevant information that is indispensable for basic and clinical investigators aiming for novel, breakthrough research as well as for cardiologists seeking to best serve their patients. Providing you with a single, concise reference tool acknowledged to be among the finest in the world, Cardiovascular Drugs and Therapy is listed in Web of Science and PubMed/Medline among other abstracting and indexing services. The regular articles and frequent special topical issues equip you with an up-to-date source defined by the need for accurate information on an ever-evolving field. Cardiovascular Drugs and Therapy is a careful and accurate guide through the maze of new products and therapies which furnishes you with the details on cardiovascular pharmacology that you will refer to time and time again.