Revising the link between proton-pump inhibitors and risk of acute myocardial infarction—a case-crossover analysis

Long‐term use of proton pump inhibitors, dose–response relationship and associated risk of ischemic stroke and myocardial infarction

“…In this nationwide study of 214 998 individuals without prior atherosclerotic disease, PPI use was associated with a significantly increased risk of ischemic stroke and MI. These associations are consistent with previous findings from other observational studies in low‐risk general populations . Additionally, we found a dose–response relationship between PPI use and both stroke and MI.…”

Systematic review with meta‐analysis: risk of adverse cardiovascular events with proton pump inhibitors independent of clopidogrel

“…The systematic search strategy identified 5285 unique articles, of which 89 were eligible for full text screening. In total, 22 studies met the inclusion criteria (including three abstracts which were excluded from meta‐analysis) . The most common reasons for study exclusion were noncardiovascular outcomes (encapsulated by the broad search strategy), and the use of concomitant anti‐platelet therapy.…”

“…Three abstracts encapsulated by the search strategy were excluded from meta‐analyses as risk of bias could not be accurately assessed . Three full text studies were excluded as they did not have comparable methodology or quantitative data that could be accurately pooled . These three excluded studies comprised a self‐matched case series, a case‐crossover study, and a cohort study …”

How May Proton Pump Inhibitors Impair Cardiovascular Health?

“…Indeed, a case-crossover study among 3490 MI cases demonstrated that PPI prescription appeared to increase the risk of MI by 70%. However, when the dispensation date of the PPI rather than prescription date was used to calculate the risk, this increase in the risk was diluted [43]. Inasmuch there was a more prominent association of MI with PPI prescription than PPI usage, this study could be interpreted as indicating a lack of cause-and-relationship effects of PPIs on MI onset.…”