PMID- 24122589
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20131021
LR  - 20160519
IS  - 1868-4300 (Print)
IS  - 1868-4297 (Linking)
VI  - 26
IP  - 3
DP  - 2011 Sep
TI  - Association of the use of proton pump inhibitors with adverse cardiovascular and 
      bleeding outcomes after percutaneous coronary intervention in the Japanese real 
      world clinical practice.
PG  - 222-33
LID - 10.1007/s12928-011-0063-2 [doi]
AB  - Previous studies have shown inconsistent results regarding the effects of 
      concomitant use of clopidogrel and proton pump inhibitors (PPI) on cardiovascular 
      outcomes. We sought to evaluate the clinical impact of PPI-use in patients 
      treated with thienopyridines after percutaneous coronary intervention (PCI) in a 
      large Japanese observational database. Among 12446 patients discharged alive on 
      thienopyridines (ticlopidine 90.4% and clopidogrel 9.6%), 3223 patients were 
      treated with PPIs and 9223 patients without PPI at the time of hospital 
      discharge. The PPI group included more patients with co-morbidities than the 
      non-PPI group. The adjusted hazard ratio (HR) of PPI-use for a composite of 
      cardiovascular death, myocardial infarction, and stroke was 1.26 (95% confidence 
      interval (CI) 1.09-1.47, p = 0.002). The adjusted HR of PPI-use for bleeding was 
      1.26 (95% CI 1.05-1.52, p = 0.013). Cardiovascular and bleeding outcomes were not 
      different among the three groups receiving three different types of PPI. The 
      negative effect of PPI on cardiovascular outcome was consistently seen in both 
      drug-eluting stent (DES) [HR 1.31 (95% CI 1.07-1.6, p = 0.0097)] and non-DES 
      strata [HR 1.25 (95% CI: 0.99-1.57, p = 0.057)] (Interaction p = 0.79) despite 
      the fact that the duration of thienopyridine administration was significantly 
      longer in patients receiving DES. In conclusion, cardiovascular outcomes after 
      PCI were significantly worse in patients with PPI than in patients without PPI in 
      the Japanese real clinical practice. However, the observed poorer cardiovascular 
      outcome in patients receiving PPI was most likely to be related to residual 
      confounding and seemed not causally related to attenuation of antiplatelet effect 
      of thienopyridine through interaction with PPI.
FAU - Kimura, Takeshi
AU  - Kimura T
AD  - Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto 
      University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan, 
      taketaka@kuhp.kyoto-u.ac.jp.
FAU - Morimoto, Takeshi
AU  - Morimoto T
FAU - Furukawa, Yutaka
AU  - Furukawa Y
FAU - Nakagawa, Yoshihisa
AU  - Nakagawa Y
FAU - Kadota, Kazushige
AU  - Kadota K
FAU - Iwabuchi, Masashi
AU  - Iwabuchi M
FAU - Shizuta, Satoshi
AU  - Shizuta S
FAU - Shiomi, Hiroki
AU  - Shiomi H
FAU - Tada, Tomohisa
AU  - Tada T
FAU - Tazaki, Junichi
AU  - Tazaki J
FAU - Kato, Yoshihiro
AU  - Kato Y
FAU - Hayano, Mamoru
AU  - Hayano M
FAU - Abe, Mitsuru
AU  - Abe M
FAU - Tamura, Takashi
AU  - Tamura T
FAU - Shirotani, Manabu
AU  - Shirotani M
FAU - Miki, Shinji
AU  - Miki S
FAU - Matsuda, Mitsuo
AU  - Matsuda M
FAU - Takahashi, Mamoru
AU  - Takahashi M
FAU - Ishii, Katsuhisa
AU  - Ishii K
FAU - Tanaka, Masaru
AU  - Tanaka M
FAU - Aoyama, Takeshi
AU  - Aoyama T
FAU - Doi, Osamu
AU  - Doi O
FAU - Hattori, Ryuichi
AU  - Hattori R
FAU - Tatami, Ryozo
AU  - Tatami R
FAU - Suwa, Satoru
AU  - Suwa S
FAU - Takizawa, Akinori
AU  - Takizawa A
FAU - Takatsu, Yoshiki
AU  - Takatsu Y
FAU - Takahashi, Masaaki
AU  - Takahashi M
FAU - Kato, Hiroshi
AU  - Kato H
FAU - Takeda, Teruki
AU  - Takeda T
FAU - Lee, Jong-Dae
AU  - Lee JD
FAU - Nohara, Ryuji
AU  - Nohara R
FAU - Tei, Chuwa
AU  - Tei C
FAU - Horie, Minoru
AU  - Horie M
FAU - Kambara, Hirofumi
AU  - Kambara H
FAU - Fujiwara, Hisayoshi
AU  - Fujiwara H
FAU - Mitsudo, Kazuaki
AU  - Mitsudo K
FAU - Nobuyoshi, Masakiyo
AU  - Nobuyoshi M
FAU - Kita, Toru
AU  - Kita T
LA  - eng
PT  - Journal Article
DEP - 20110512
PL  - Japan
TA  - Cardiovasc Interv Ther
JT  - Cardiovascular intervention and therapeutics
JID - 101522043
EDAT- 2011/09/01 00:00
MHDA- 2011/09/01 00:01
CRDT- 2013/10/15 06:00
PHST- 2011/01/06 00:00 [received]
PHST- 2011/03/09 00:00 [accepted]
PHST- 2013/10/15 06:00 [entrez]
PHST- 2011/09/01 00:00 [pubmed]
PHST- 2011/09/01 00:01 [medline]
AID - 10.1007/s12928-011-0063-2 [doi]
PST - ppublish
SO  - Cardiovasc Interv Ther. 2011 Sep;26(3):222-33. doi: 10.1007/s12928-011-0063-2. 
      Epub 2011 May 12.