PMID- 32692459
OWN - NLM
STAT- MEDLINE
DCOM- 20210726
LR  - 20210726
IS  - 1365-2125 (Electronic)
IS  - 0306-5251 (Linking)
VI  - 87
IP  - 3
DP  - 2021 Mar
TI  - Use of proton pump inhibitors is associated with lower rates of first-time 
      ischemic stroke in community-dwelling elderly.
PG  - 1187-1193
LID - 10.1111/bcp.14488 [doi]
AB  - AIM: Data on cardiovascular outcomes in elderly using proton pump inhibitors 
      (PPI) are scant. We aimed to test the association between PPI use and the 
      occurrence of first-time ischemic stroke (FTIS) among elderly. METHODS: The 
      electronic database of a centrally located district branch of a large health 
      maintenance organization in Israel was retrospectively screened (2002-2016) for 
      community-dwelling individuals (>/=65-95 years) for demographics and 
      co-morbidities. Follow-up was until FTIS, death or end of study. Findings were 
      analyzed by PPI use and occurrence of FTIS. RESULTS: 29,639 subjects (without 
      history of stroke and use of antiplatelet aggregation drugs) mean age of 82.2 +/- 
      5.5 years (range: 65-95 years, 38% male) were analyzed: 8,600 (29%) used PPIs. 
      Mean follow up was 10.58 years (SD +/- 5.44). Similar total and annual occurrence 
      rates of FTIS were depicted in PPI users and non-users (20.9% vs. 21% and 2% vs. 
      2.1%, respectively). On a Cox regression analysis, upon adjustment for age, 
      gender and cardiovascular disease related risk factors, PPI use was significantly 
      associated with lower rates of FTIS (HR 0.73, 95% C.I. 0.69-0.77, p < 0.001). The 
      risk for FTIS was significantly lower in subjects using PPI at any dose and for 
      any time period compared to non-users (HR 0.9, 95% C.I. 0.85-0.96 for 7-48 yearly 
      prescriptions and HR 0.51, 95% C.I. 0.46-0.55 for >/=49 yearly prescriptions). 
      CONCLUSIONS: PPI use was associated with lower rates of FTIS in 
      community-dwelling elders. Prospective large-scale studies are needed to fully 
      elucidate the effect of PPI in this aging population.
CI  - (c) 2020 The British Pharmacological Society.
FAU - Schmilovitz-Weiss, Hemda
AU  - Schmilovitz-Weiss H
AD  - Division of Gastroenterology, Hasharon Hospital, Rabin Medical Center, Petach 
      Tikva 4937211, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
FAU - Gingold-Belfer, Rachel
AU  - Gingold-Belfer R
AUID- ORCID: 0000-0002-2831-4402
AD  - Division of Gastroenterology, Beilinson Hospital, Rabin Medical Center, Petach 
      Tikva 4941492, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
FAU - Peleg, Noam
AU  - Peleg N
AD  - Division of Gastroenterology, Beilinson Hospital, Rabin Medical Center, Petach 
      Tikva 4941492, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
FAU - Grossman, Alon
AU  - Grossman A
AD  - Department of Internal Medicine B, Beilinson Hospital, Rabin Medical Center, 
      Petach Tikva 4941492, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
FAU - Issa, Nidal
AU  - Issa N
AD  - Department of Surgery B, Hasharon Hospital, Rabin Medical Center, Petach Tikva 
      4937211, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
FAU - Boltin, Doron
AU  - Boltin D
AD  - Division of Gastroenterology, Beilinson Hospital, Rabin Medical Center, Petach 
      Tikva 4941492, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
FAU - Beloosesky, Yichayaou
AU  - Beloosesky Y
AD  - Department of Geriatrics, Beilinson Hospital, Rabin Medical Center, Petach Tikva 
      4941492, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
FAU - Koren-Morag, Nira
AU  - Koren-Morag N
AD  - Department of Epidemiology, Beilinson Hospital, Rabin Medical Center, Petach 
      Tikva 4941492, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
FAU - Meyerovitch, Joseph
AU  - Meyerovitch J
AD  - Community Division, Clalit Health Services, Dan-Petach Tikva District, Petach 
      Tikva, Israel.
FAU - Shirin, Haim
AU  - Shirin H
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
AD  - Shamir Medical Center, Institute of Gastroenterology Liver disease and Nutrition, 
      Be'er Yaakov, 7033001, Israel.
FAU - Weiss, Avraham
AU  - Weiss A
AD  - Department of Geriatrics, Beilinson Hospital, Rabin Medical Center, Petach Tikva 
      4941492, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
LA  - eng
PT  - Journal Article
DEP - 20200813
PL  - England
TA  - Br J Clin Pharmacol
JT  - British journal of clinical pharmacology
JID - 7503323
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Brain Ischemia/epidemiology
MH  - Female
MH  - Humans
MH  - Independent Living
MH  - *Ischemic Stroke
MH  - Israel/epidemiology
MH  - Male
MH  - Platelet Aggregation Inhibitors/adverse effects
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/adverse effects
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Stroke/epidemiology
OTO - NOTNLM
OT  - Elders
OT  - First time ischemic stroke (FTIS)
OT  - Proton pump inhibitors (PPI)
EDAT- 2020/07/22 06:00
MHDA- 2021/07/27 06:00
CRDT- 2020/07/22 06:00
PHST- 2020/03/31 00:00 [received]
PHST- 2020/06/04 00:00 [revised]
PHST- 2020/07/09 00:00 [accepted]
PHST- 2020/07/22 06:00 [pubmed]
PHST- 2021/07/27 06:00 [medline]
PHST- 2020/07/22 06:00 [entrez]
AID - 10.1111/bcp.14488 [doi]
PST - ppublish
SO  - Br J Clin Pharmacol. 2021 Mar;87(3):1187-1193. doi: 10.1111/bcp.14488. Epub 2020 
      Aug 13.