PMID- 33151969
OWN - NLM
STAT- MEDLINE
DCOM- 20201223
LR  - 20201223
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 15
IP  - 11
DP  - 2020
TI  - Current status of proton pump inhibitor use in Japanese elderly patients with 
      non-valvular atrial fibrillation: A subanalysis of the ANAFIE Registry.
PG  - e0240859
LID - 10.1371/journal.pone.0240859 [doi]
LID - e0240859
AB  - The real-world status of proton pump inhibitor (PPI) use in patients with atrial 
      fibrillation (AF) receiving antithrombotic treatment is largely unknown. The All 
      Nippon AF In the Elderly (ANAFIE) Registry, a prospective, multicenter, 
      observational study, aimed to determine treatment patterns, risk factors, and 
      outcomes among elderly (aged >/=75 years) Japanese non-valvular AF (NVAF) patients 
      in the real-world clinical setting. The present subanalysis of the ANAFIE 
      Registry determined the PPI prescription status of 32,490 elderly Japanese NVAF 
      patients. Patients were stratified by PPI use (PPI+) or no PPI use (PPI-). Risk 
      scores for stroke (CHADS2, CHA2DS2-VASc) and bleeding (HAS-BLED), anticoagulant 
      use, time in therapeutic range (TTR) for warfarin, and anticoagulant/antiplatelet 
      combination use were evaluated. PPIs were used in 11,981 (36.9%) patients. 
      Compared with the PPI- group, the PPI+ group included a greater proportion of 
      female patients (45.2% vs 41.3%; P <0.0001) and had significantly higher CHADS2, 
      CHA2DS2-VASc, and HAS-BLED scores (P <0.0001 for each) as well as higher 
      prevalences of several comorbidities. In the PPI+ group, 54.6% of patients did 
      not have gastrointestinal (GI) disorders and were likely prescribed a PPI to 
      prevent GI bleeding events. Most of the patients with a GI disorder in the PPI+ 
      group had reflux esophagitis. Compared with patients not receiving 
      anticoagulants, a significantly higher proportion of patients receiving 
      anticoagulants received PPIs. For patients receiving anticoagulants, antiplatelet 
      drugs, and both drugs, rates of PPI use were 34.1%, 44.1%, and 53.5%, 
      respectively (P <0.01). Although the rate of PPI use was the highest for NVAF 
      patients receiving both antiplatelet and anticoagulants, no clear differences 
      were observed in the anticoagulants used. These data suggest that PPIs were 
      actively prescribed in high-risk cases and may have been used to prevent GI 
      bleeding among elderly NVAF patients receiving antithrombotic drugs. Trial 
      registration: UMIN000024006.
FAU - Mizokami, Yuji
AU  - Mizokami Y
AD  - Department of Gastroenterology, University of Tsukuba Hospital, Tsukuba, Ibaraki, 
      Japan.
FAU - Yamamoto, Takatsugu
AU  - Yamamoto T
AUID- ORCID: 0000-0001-7425-823X
AD  - Department of Medicine, Teikyo University, Itabashi City, Tokyo, Japan.
FAU - Atarashi, Hirotsugu
AU  - Atarashi H
AD  - Minami Hachioji Hospital, Hachioji, Tokyo, Japan.
FAU - Yamashita, Takeshi
AU  - Yamashita T
AD  - The Cardiovascular Research Institute, Minato City, Tokyo, Japan.
FAU - Akao, Masaharu
AU  - Akao M
AD  - National Hospital Organization Kyoto Medical Center, Fushimi Ward, Kyoto, Japan.
FAU - Ikeda, Takanori
AU  - Ikeda T
AD  - Toho University Omori Medical Center, Ota City, Tokyo, Japan.
FAU - Koretsune, Yukihiro
AU  - Koretsune Y
AD  - National Hospital Organization Osaka National Hospital, Chuo Ward, Osaka, Japan.
FAU - Okumura, Ken
AU  - Okumura K
AD  - Saiseikai Kumamoto Hospital, Minami Ward, Kumamoto, Japan.
FAU - Shimizu, Wataru
AU  - Shimizu W
AD  - Nippon Medical School, Bunkyo City, Tokyo, Japan.
FAU - Tsutsui, Hiroyuki
AU  - Tsutsui H
AD  - Kyushu University, Higashi Ward, Fukuoka, Japan.
FAU - Toyoda, Kazunori
AU  - Toyoda K
AD  - National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
FAU - Hirayama, Atsushi
AU  - Hirayama A
AD  - Osaka Police Hospital, Tennoji Ward, Osaka, Japan.
FAU - Yasaka, Masahiro
AU  - Yasaka M
AD  - National Hospital Organization Kyushu Medical Center, Chuo Ward, Fukuoka, Japan.
FAU - Yamaguchi, Takenori
AU  - Yamaguchi T
AD  - National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
FAU - Teramukai, Satoshi
AU  - Teramukai S
AD  - Kyoto Prefectural University of Medicine, Kamigyo Ward, Kyoto, Japan.
FAU - Kimura, Tetsuya
AU  - Kimura T
AD  - Medical Science Department, Daiichi Sankyo Co., Ltd., Chuo City, Tokyo, Japan.
FAU - Kaburagi, Jumpei
AU  - Kaburagi J
AD  - Medical Science Department, Daiichi Sankyo Co., Ltd., Chuo City, Tokyo, Japan.
FAU - Takita, Atsushi
AU  - Takita A
AD  - Biostatistics and Data Management Department, Daiichi Sankyo Co., Ltd., 
      Shinagawa-ku, Tokyo, Japan.
FAU - Inoue, Hiroshi
AU  - Inoue H
AD  - Saiseikai Toyama Hospital, Toyama, Toyama, Japan.
LA  - eng
SI  - UMIN-CTR/UMIN000024006
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20201105
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/administration & dosage/adverse effects/therapeutic use
MH  - Atrial Fibrillation/complications/*drug therapy
MH  - Cohort Studies
MH  - Drug Therapy, Combination
MH  - Female
MH  - Hemorrhage/epidemiology/etiology/prevention & control
MH  - Humans
MH  - Japan/epidemiology
MH  - Male
MH  - Platelet Aggregation Inhibitors/administration & dosage/adverse 
      effects/therapeutic use
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/administration & dosage/*therapeutic use
MH  - Registries
MH  - Risk Factors
MH  - Stroke/epidemiology/etiology/prevention & control
PMC - PMC7644054
COIS- The authors have read the journal's policy and have the following potential 
      competing interests: Tetsuya Kimura, Jumpei Kaburagi, and Atsushi Takita are paid 
      employees of Daiichi Sankyo Co., Ltd., Tokyo, Japan. Yuji Mizokami received 
      research funding from Daiichi Sankyo, and remuneration from Daiichi Sankyo. 
      Takatsugu Yamamoto received remuneration from Nippon Boehringer Ingelheim, 
      Bristol-Myers Squibb, Takeda Pharmaceutical, Otsuka Pharmaceutical, and 
      AstraZeneca. Hirotsugu Atarashi received remuneration from Daiichi Sankyo. 
      Takeshi Yamashita received research funding from Bristol-Myers Squibb, Bayer, and 
      Daiichi Sankyo, manuscript fees from Daiichi Sankyo and Bristol-Myers Squibb, and 
      remuneration from Daiichi Sankyo, Bayer, Pfizer Japan, and Bristol-Myers Squibb. 
      Masaharu Akao received research funding from Bayer and Daiichi Sankyo, and 
      remuneration from Bristol-Myers Squibb, Nippon Boehringer Ingelheim, Bayer, and 
      Daiichi Sankyo. Takanori Ikeda received research funding from Daiichi Sankyo and 
      Bayer, and remuneration from Daiichi Sankyo, Bayer, Nippon Boehringer Ingelheim, 
      and Bristol-Myers Squibb. Yukihiro Koretsune received remuneration from Daiichi 
      Sankyo, Bayer, and Nippon Boehringer Ingelheim. Ken Okumura received remuneration 
      from Nippon Boehringer Ingelheim, Daiichi Sankyo, Johnson & Johnson, and 
      Medtronic. Wataru Shimizu received research funding from Bristol-Myers Squibb, 
      Daiichi Sankyo, and Nippon Boehringer Ingelheim, and patent royalties/licensing 
      fees from Daiichi Sankyo, Pfizer Japan, Bristol-Myers Squibb, Bayer, and Nippon 
      Boehringer Ingelheim. Hiroyuki Tsutsui received research funding from Daiichi 
      Sankyo and Nippon Boehringer Ingelheim, remuneration from Daiichi Sankyo, Bayer, 
      Nippon Boehringer Ingelheim, and Pfizer Japan, scholarship funding from Daiichi 
      Sankyo, and consultancy fees from Pfizer Japan, Bayer, and Nippon Boehringer 
      Ingelheim. Kazunori Toyoda received remuneration from Daiichi Sankyo, Bayer, 
      Bristol-Myers Squibb, and Nippon Boehringer Ingelheim. Atsushi Hirayama 
      participated in a course endowed by Boston Scientific Japan, and has received 
      research funding from Daiichi Sankyo and Bayer, and remuneration from Bayer, 
      Daiichi Sankyo, Bristol-Myers Squibb, and Nippon Boehringer Ingelheim. Masahiro 
      Yasaka received research funding from Nippon Boehringer Ingelheim, and 
      remuneration from Nippon Boehringer Ingelheim, Daiichi Sankyo, Bayer, 
      Bristol-Myers Squibb, and Pfizer Japan. Takenori Yamaguchi acted as an Advisory 
      Board member of Daiichi Sankyo and received remuneration from Daiichi Sankyo and 
      Bristol-Myers Squibb. Satoshi Teramukai received research funding from Nippon 
      Boehringer Ingelheim and remuneration from Daiichi Sankyo. Tetsuya Kimura, Jumpei 
      Kaburagi, and Atsushi Takita are employees of Daiichi Sankyo. Hiroshi Inoue 
      received remuneration from Daiichi Sankyo, Bayer, Bristol-Myers Squibb, and 
      Nippon Boehringer Ingelheim. This does not alter our adherence to PLOS ONE 
      policies on sharing data and materials. The authors would like to declare the 
      following patents/patent applications associated with this research: Daiichi 
      Sankyo has launched Nexium(R) (esomeprazole magnesium hydrate) which is one of the 
      proton pump inhibitors.
EDAT- 2020/11/06 06:00
MHDA- 2020/12/29 06:00
PMCR- 2020/11/05
CRDT- 2020/11/05 17:13
PHST- 2020/06/01 00:00 [received]
PHST- 2020/10/04 00:00 [accepted]
PHST- 2020/11/05 17:13 [entrez]
PHST- 2020/11/06 06:00 [pubmed]
PHST- 2020/12/29 06:00 [medline]
PHST- 2020/11/05 00:00 [pmc-release]
AID - PONE-D-20-16058 [pii]
AID - 10.1371/journal.pone.0240859 [doi]
PST - epublish
SO  - PLoS One. 2020 Nov 5;15(11):e0240859. doi: 10.1371/journal.pone.0240859. 
      eCollection 2020.