PMID- 28763306
OWN - NLM
STAT- MEDLINE
DCOM- 20180521
LR  - 20180521
IS  - 1536-3686 (Electronic)
IS  - 1075-2765 (Linking)
VI  - 24
IP  - 5
DP  - 2017 Sep/Oct
TI  - Efficacy and Safety of Proton Pump Inhibitors in the Long-Term Aspirin Users: A 
      Meta-Analysis of Randomized Controlled Trials.
PG  - e559-e569
LID - 10.1097/MJT.0000000000000637 [doi]
AB  - BACKGROUND: Long-term aspirin use in cardiovascular disease prevention may result 
      in gastrointestinal bleeding. Although proton pump inhibitors (PPI) have been 
      shown to reduce the risks of peptic ulcers and dyspeptic symptoms in long-term 
      aspirin users in the randomized controlled trials, there are safety concerns 
      about the long-term use of PPI. STUDY QUESTION: What is the safety and efficacy 
      of PPI in patients using aspirin in long term for prevention of cardiovascular 
      diseases and stroke? METHODS: We searched MEDLINE, EMBASE, CENTRAL, CINAHL, 
      ProQuest, and relevant references from inception through February 2015, and used 
      random-effects model for meta-analysis. RESULTS: A total of 10 publications from 
      9 studies (n = 6382) were included in the meta-analysis. Compared with control, 
      PPI reduced the risks of peptic ulcers [risk ratio (RR): 0.19; 95% confidence 
      interval: 0.13-0.26; P < 0.00001], gastric ulcers [0.24 (0.16-0.35); P < 
      0.00001], duodenal ulcers [0.12 (0.05-0.29); P < 0.00001], bleeding ulcers [0.22 
      (0.10-0.51); P = 0.0004], and erosive esophagitis [0.14 (0.07-0.28); P < 
      0.00001]. PPI increased the resolution of epigastric pain [1.13 (1.03-1.25); P = 
      0.01], heartburn [1.24 (1.18-1.31); P < 0.00001], and regurgitation [1.26 
      (1.13-1.40); P < 0.0001], but did not increase the risks of all-cause mortality 
      [1.72 (0.61-4.87); P = 0.31], cardiovascular mortality [1.80 (0.59-5.44); P = 
      0.30], nonfatal myocardial infarction/ischemia [0.56 (0.22-1.41); P = 0.22], 
      ischemic stroke/transient ischemic attack [1.09 (0.34-3.53); P = 0.89] and other 
      adverse events. CONCLUSIONS: The PPI seems to be effective in preventing peptic 
      ulcers and erosive esophagitis and in resolution of dyspeptic symptoms without 
      increasing adverse events, cardiac risks or mortality in long-term aspirin users.
FAU - Dahal, Khagendra
AU  - Dahal K
AD  - 1Louisiana State University Health Science Center, Department of Medicine, 
      Division of Cardiology, Shreveport, LA; and 2Department of Medicine, Lakes Region 
      General Healthcare, University of New England, Laconia, NH.
FAU - Sharma, Sharan P
AU  - Sharma SP
FAU - Kaur, Jaspreet
AU  - Kaur J
FAU - Anderson, Billie J
AU  - Anderson BJ
FAU - Singh, Gurpinder
AU  - Singh G
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PL  - United States
TA  - Am J Ther
JT  - American journal of therapeutics
JID - 9441347
RN  - 0 (Proton Pump Inhibitors)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Aspirin/*therapeutic use
MH  - Esophagitis, Peptic/chemically induced/*epidemiology/prevention & control
MH  - Humans
MH  - Myocardial Infarction/mortality/*prevention & control
MH  - Odds Ratio
MH  - Peptic Ulcer/chemically induced/complications/*epidemiology/prevention & control
MH  - Peptic Ulcer Hemorrhage/*epidemiology/etiology/prevention & control
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Stroke/mortality/*prevention & control
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2017/08/02 06:00
MHDA- 2018/05/22 06:00
CRDT- 2017/08/02 06:00
PHST- 2017/08/02 06:00 [pubmed]
PHST- 2018/05/22 06:00 [medline]
PHST- 2017/08/02 06:00 [entrez]
AID - 10.1097/MJT.0000000000000637 [doi]
PST - ppublish
SO  - Am J Ther. 2017 Sep/Oct;24(5):e559-e569. doi: 10.1097/MJT.0000000000000637.