PMID- 34380699
OWN - NLM
STAT- MEDLINE
DCOM- 20211124
LR  - 20220531
IS  - 2054-4774 (Print)
IS  - 2054-4774 (Electronic)
IS  - 2054-4774 (Linking)
VI  - 8
IP  - 1
DP  - 2021 Aug
TI  - Association between proton pump inhibitors after percutaneous coronary 
      intervention and risk of gastric cancer.
LID - 10.1136/bmjgast-2021-000719 [doi]
LID - e000719
AB  - BACKGROUND: Previous studies showing an association between chronic use of proton 
      pump inhibitor (PPI) and gastric cancer are limited by confounding by indication. 
      This relationship has not been studied in patients receiving PPI for prophylaxis, 
      such as those undergoing percutaneous coronary intervention (PCI). METHOD: This 
      was a retrospective cohort study including 14 hospitals under the Hospital 
      Authority of Hong Kong between 1 January 2004 and 31 December 2017. Participants 
      were patients who underwent first-ever PCI, were not on PPI prescription within 
      30 days before admission for PCI, had no known malignancy and survived for 365 
      days after PCI. Propensity score matching was used to balance baseline 
      characteristics and other prescription patterns. The primary outcome was 
      diagnosis of gastric cancer made >365 days after PCI as a time-to-first-event 
      analysis. The secondary outcome was death from gastric cancer. RESULTS: Among the 
      13 476 patients (6738 pairs) matched by propensity score, gastric cancer 
      developed in 17 (0.25%) PPI users and 7 (0.10%) PPI non-users after a median 
      follow-up of 7.1 years. PPI users had a higher risk of gastric cancer (HR 3.55; 
      95% CI 1.46 to 8.66, p=0.005) and death from gastric cancer (HR 4.18; 95% CI 1.09 
      to 16.08, p=0.037), compared with non-users. The association was 
      duration-dependent and patients who took PPI for >/=365 days were at increased 
      risk. CONCLUSIONS: Chronic use of PPI was significantly associated with increased 
      risk of gastric cancer and death from gastric cancer in patients for whom it was 
      prescribed as prophylaxis. Physicians should judiciously assess the relevant 
      risks and benefits of chronic PPI use before prescription.
CI  - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Ng, Andrew Kei-Yan
AU  - Ng AK
AUID- ORCID: 0000-0002-5553-016X
AD  - Cardiac Medical Unit, Grantham Hospital, Hong Kong, Hong Kong 
      drandrewkyng@gmail.com.
FAU - Ng, Pauline Yeung
AU  - Ng PY
AD  - Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.
FAU - Ip, April
AU  - Ip A
AD  - Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.
FAU - Cheung, Ka-Shing
AU  - Cheung KS
AD  - Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.
FAU - Siu, Chung-Wah
AU  - Siu CW
AD  - Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.
LA  - eng
PT  - Journal Article
PL  - England
TA  - BMJ Open Gastroenterol
JT  - BMJ open gastroenterology
JID - 101660690
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Humans
MH  - *Percutaneous Coronary Intervention
MH  - Propensity Score
MH  - Proton Pump Inhibitors/adverse effects
MH  - Retrospective Studies
MH  - *Stomach Neoplasms/epidemiology
PMC - PMC8359470
OTO - NOTNLM
OT  - gastric acid
OT  - gastric cancer
OT  - proton pump inhibition
COIS- Competing interests: None declared.
EDAT- 2021/08/13 06:00
MHDA- 2021/11/25 06:00
PMCR- 2021/08/11
CRDT- 2021/08/12 05:41
PHST- 2021/06/02 00:00 [received]
PHST- 2021/07/17 00:00 [accepted]
PHST- 2021/08/12 05:41 [entrez]
PHST- 2021/08/13 06:00 [pubmed]
PHST- 2021/11/25 06:00 [medline]
PHST- 2021/08/11 00:00 [pmc-release]
AID - bmjgast-2021-000719 [pii]
AID - 10.1136/bmjgast-2021-000719 [doi]
PST - ppublish
SO  - BMJ Open Gastroenterol. 2021 Aug;8(1):e000719. doi: 10.1136/bmjgast-2021-000719.