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...

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Main Authors: 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
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
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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.
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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
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