Proton Pump Inhibitors and Cardiovascular Events: A Systematic Review.

Area of Science:

• Cardiology
• Pharmacology
• Epidemiology

Background:

• Proton pump inhibitors (PPIs) are widely prescribed medications.
• Emerging data suggests a potential link between PPI use and increased cardiovascular and all-cause morbidity.
• This study addresses the need for a comprehensive review of PPIs' impact on morbidity and mortality.

Purpose of the Study:

• To systematically review and investigate the association between proton pump inhibitor (PPI) use and morbidity and mortality.
• To synthesize evidence from existing studies to clarify the risks associated with PPIs.

Main Methods:

• A systematic review was conducted following PRISMA guidelines.
• Searches were performed in PubMed, Medline, and the Cochrane Review Database for English-language studies published between January 1990 and October 2016.
• Dichotomous analysis using odds ratios was employed for data synthesis.

Main Results:

• Thirty-seven studies were included in the review.
• Analysis of five comparative studies revealed significantly higher all-cause mortality (OR 1.68 [95% CI 1.53-1.84]) and major cardiovascular events (OR 1.54 [95% CI 1.11-2.13]) in patients taking PPIs.
• The study datasets included 22,427 patients for mortality and 354,446 patients for morbidity.

Conclusions:

• The systematic review confirms a significant increase in cardiovascular morbidity among patients using PPIs.
• Clinical equipoise warrants careful consideration regarding PPI prescription.
• Further research is essential to fully elucidate the long-term effects and risks associated with PPIs.