Associations of Acid Suppressive Therapy With Cardiac Mortality in Heart Failure Patients
BackgroundIt has been recently reported that histamine H2 receptor antagonists (H2RAs) are associated with impairment of ventricular remodeling and incident heart failure. In addition, favorable pleiotropic effects and adverse effects of proton pump inhibitors (PPIs) on cardiovascular disease have a...
Main Authors: | , , , , , , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Wiley
2017-05-01
|
Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
Subjects: | |
Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.005110 |
_version_ | 1818315138010185728 |
---|---|
author | Akiomi Yoshihisa Mai Takiguchi Yuki Kanno Akihiko Sato Tetsuro Yokokawa Shunsuke Miura Satoshi Abe Tomofumi Misaka Takamasa Sato Satoshi Suzuki Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Hiroyuki Kunii Kazuhiko Nakazato Hitoshi Suzuki Shu‐ichi Saitoh Yasuchika Takeishi |
author_facet | Akiomi Yoshihisa Mai Takiguchi Yuki Kanno Akihiko Sato Tetsuro Yokokawa Shunsuke Miura Satoshi Abe Tomofumi Misaka Takamasa Sato Satoshi Suzuki Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Hiroyuki Kunii Kazuhiko Nakazato Hitoshi Suzuki Shu‐ichi Saitoh Yasuchika Takeishi |
author_sort | Akiomi Yoshihisa |
collection | DOAJ |
description | BackgroundIt has been recently reported that histamine H2 receptor antagonists (H2RAs) are associated with impairment of ventricular remodeling and incident heart failure. In addition, favorable pleiotropic effects and adverse effects of proton pump inhibitors (PPIs) on cardiovascular disease have also been reported. We examined the associations of acid suppressive therapy using H2RAs or PPIs with cardiac mortality in patients with heart failure. Methods and ResultsIn total, 1191 consecutive heart failure patients were divided into 3 groups: a non–acid suppressive therapy group (n=363), an H2RA group (n=164), and a PPI group (n=664). In the follow‐up period (mean 995 days), 169 cardiac deaths occurred. In the Kaplan–Meier analysis, cardiac mortality was significantly lower in the PPI group than in the H2RA and non–acid suppressive therapy groups (11.0% versus 21.3% and 16.8%, respectively; log‐rank P=0.004). In the multivariable Cox proportional hazards analysis, use of PPIs, but not H2RAs, was found to be an independent predictor of cardiac mortality (PPIs: hazard ratio 0.488, P=0.002; H2RAs: hazard ratio 0.855, P=0.579). The propensity‐matched 1:1 cohort was assessed based on propensity score (H2RAs, n=164; PPIs, n=164). Cardiac mortality was significantly lower in the PPI group than in the H2RA group in the postmatched cohort (log‐rank P=0.025). In the Cox proportional hazards analysis, the use of PPIs was a predictor of cardiac mortality in the postmatched cohort (hazard ratio 0.528, P=0.028). ConclusionsPPIs may be associated with better outcome in patients with heart failure. |
first_indexed | 2024-12-13T09:00:46Z |
format | Article |
id | doaj.art-9ccd7b8f9e424230ae611019ab59ae4e |
institution | Directory Open Access Journal |
issn | 2047-9980 |
language | English |
last_indexed | 2024-12-13T09:00:46Z |
publishDate | 2017-05-01 |
publisher | Wiley |
record_format | Article |
series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
spelling | doaj.art-9ccd7b8f9e424230ae611019ab59ae4e2022-12-21T23:53:11ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-05-016510.1161/JAHA.116.005110Associations of Acid Suppressive Therapy With Cardiac Mortality in Heart Failure PatientsAkiomi Yoshihisa0Mai Takiguchi1Yuki Kanno2Akihiko Sato3Tetsuro Yokokawa4Shunsuke Miura5Satoshi Abe6Tomofumi Misaka7Takamasa Sato8Satoshi Suzuki9Masayoshi Oikawa10Atsushi Kobayashi11Takayoshi Yamaki12Hiroyuki Kunii13Kazuhiko Nakazato14Hitoshi Suzuki15Shu‐ichi Saitoh16Yasuchika Takeishi17Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanBackgroundIt has been recently reported that histamine H2 receptor antagonists (H2RAs) are associated with impairment of ventricular remodeling and incident heart failure. In addition, favorable pleiotropic effects and adverse effects of proton pump inhibitors (PPIs) on cardiovascular disease have also been reported. We examined the associations of acid suppressive therapy using H2RAs or PPIs with cardiac mortality in patients with heart failure. Methods and ResultsIn total, 1191 consecutive heart failure patients were divided into 3 groups: a non–acid suppressive therapy group (n=363), an H2RA group (n=164), and a PPI group (n=664). In the follow‐up period (mean 995 days), 169 cardiac deaths occurred. In the Kaplan–Meier analysis, cardiac mortality was significantly lower in the PPI group than in the H2RA and non–acid suppressive therapy groups (11.0% versus 21.3% and 16.8%, respectively; log‐rank P=0.004). In the multivariable Cox proportional hazards analysis, use of PPIs, but not H2RAs, was found to be an independent predictor of cardiac mortality (PPIs: hazard ratio 0.488, P=0.002; H2RAs: hazard ratio 0.855, P=0.579). The propensity‐matched 1:1 cohort was assessed based on propensity score (H2RAs, n=164; PPIs, n=164). Cardiac mortality was significantly lower in the PPI group than in the H2RA group in the postmatched cohort (log‐rank P=0.025). In the Cox proportional hazards analysis, the use of PPIs was a predictor of cardiac mortality in the postmatched cohort (hazard ratio 0.528, P=0.028). ConclusionsPPIs may be associated with better outcome in patients with heart failure.https://www.ahajournals.org/doi/10.1161/JAHA.116.005110acid suppressive therapyheart failurehistamine H2 receptor antagonistsprognosisproton pump inhibitors |
spellingShingle | Akiomi Yoshihisa Mai Takiguchi Yuki Kanno Akihiko Sato Tetsuro Yokokawa Shunsuke Miura Satoshi Abe Tomofumi Misaka Takamasa Sato Satoshi Suzuki Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Hiroyuki Kunii Kazuhiko Nakazato Hitoshi Suzuki Shu‐ichi Saitoh Yasuchika Takeishi Associations of Acid Suppressive Therapy With Cardiac Mortality in Heart Failure Patients Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acid suppressive therapy heart failure histamine H2 receptor antagonists prognosis proton pump inhibitors |
title | Associations of Acid Suppressive Therapy With Cardiac Mortality in Heart Failure Patients |
title_full | Associations of Acid Suppressive Therapy With Cardiac Mortality in Heart Failure Patients |
title_fullStr | Associations of Acid Suppressive Therapy With Cardiac Mortality in Heart Failure Patients |
title_full_unstemmed | Associations of Acid Suppressive Therapy With Cardiac Mortality in Heart Failure Patients |
title_short | Associations of Acid Suppressive Therapy With Cardiac Mortality in Heart Failure Patients |
title_sort | associations of acid suppressive therapy with cardiac mortality in heart failure patients |
topic | acid suppressive therapy heart failure histamine H2 receptor antagonists prognosis proton pump inhibitors |
url | https://www.ahajournals.org/doi/10.1161/JAHA.116.005110 |
work_keys_str_mv | AT akiomiyoshihisa associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT maitakiguchi associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT yukikanno associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT akihikosato associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT tetsuroyokokawa associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT shunsukemiura associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT satoshiabe associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT tomofumimisaka associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT takamasasato associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT satoshisuzuki associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT masayoshioikawa associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT atsushikobayashi associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT takayoshiyamaki associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT hiroyukikunii associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT kazuhikonakazato associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT hitoshisuzuki associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT shuichisaitoh associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients AT yasuchikatakeishi associationsofacidsuppressivetherapywithcardiacmortalityinheartfailurepatients |