质子抑制剂和心血管不良事件:随机对照试验的元分析
Andrew D Mosholder1, Manila Hada2, Kira Leishear1
1Division of Epidemiology 1, US Food and Drug Administration Center for Drug Evaluation and Research, Silver Spring, Maryland, USA.
The American journal of gastroenterology
|August 29, 2024
概括
质子抑制剂 (PPI) 的使用在随机试验的元分析中没有显示心血管风险增加. 虽然一些胃食道逆流障碍试验表明略有增加,但总体发现表明PPI对心脏健康是安全的.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 观察性研究表明,与质子抑制剂 (PPI) 使用相关的潜在心血管风险.
- 这些观测数据可能容易产生偏见,需要更强有力的证据.
研究的目的:
- 通过分析随机对照试验 (RCT) 的数据,评估质子抑制剂 (PPI) 的心血管安全性.
- 确定PPI治疗与主要心血管不良事件 (MACE+) 之间的关联.
主要方法:
- 进行了PPI制造商临床试验计划数据的元分析.
- 包括的RCT有≥100个受试者,持续时间>30天,以及非PPI比较器.
- 主要分析使用了MACE+的发病率比率,MACE+是心血管事件的复合结果.
主要成果:
- 总的来说,在PPI治疗和MACE+事件之间没有发现显著的关联 (总结发病率比率:0.72).
- 观察到异质性,胃食道逆流障碍试验显示每100人年可能超过1.04个MACE+事件.
- 与主动对照的比较通常表明,与PPI的积极发病率差异.
结论:
- 分析发现,PPI治疗与心血管事件之间没有总体关联.
- 在患有胃食道逆流障碍的PPI使用者中,心血管事件的潜在增加需要谨慎解释,因为数据有限.
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