Do proton pump inhibitors cause heart attacks?

shutterstock_180109973

shutterstock_180109973

There has been concern for several years about commonly prescribed antacid drugs called proton pump inhibitors (PPIs) and the heart.  PPIs are used to treat gastroesophageal reflux disease (GERD), peptic ulcer disease, and other acid-related diseases.  Common drugs in the PPI class are omeprazole (Prilosec), esomeprazole (Nexium), pantoprazole (Protonix), lansoprazole (Prevacid), and dexlansoprazole (Dexilant), among others.

Specifically, there is a potential interaction between certain PPIs and clopidogrel (Plavix), where the net result is that the effectiveness of clopidogrel may be lowered by coadministration with PPIs.  Clopidogrel is an antiplatelet drug that is often given to patients who receive cardiac stents, and it happens to be metabolized to its active form by the same liver enzyme that metabolizes most PPIs.  The drugs compete for the enzyme, and this can lower the effect of clopidogrel.  Theoretically, this can lead to adverse cardiac outcomes in patients with stents.  This in vitro effect was not found clinically meaningful in a recent randomized controlled trial, however the PPI-Plavix interaction is still a controversial topic and further details are beyond the scope of this article.

I bring up the PPI/clopidogrel issue because it becomes important in understanding a new study published this month in the journal PLoS ONE.  This study used a technique called “data-mining” to extract information from years of electronic medical records (EMRs) and included about 70 thousand patients in their primary analysis.  They describe the data-mining technique in the article, which seems to boil down to assigning a mathematical function to certain defined variables (patients taking PPIs) and an outcome (heart attack) to see if the two events are associated.

Continue reading …

Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.


Advertisements

Published by

Liposuction of Miami

Liposuction of Miami is a cosmetic surgery center that specializes in surgical body sculpting and cosmetic surgery. Our surgeon is one of the first physicians in Miami to always offer you the newest, safest, most current surgical methods of permanent fat removal.. We have helped to initiate newer, more advanced liposuction techniques and instruments that have practically done away with the trauma of older techniques.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s