Proton Pump Inhibitor (PPI) Heart Attack

Recent evidence shows that users of common heartburn medications could put themselves at an increased risk for myocardial infarction. The information comes from a data mining study conducted at Stanford University that included electronic records from nearly 3 million patients.

The medications are known as proton pump inhibitors (PPIs) and are used to suppress stomach acid and prevent heartburn, indigestion, and other gastrointestinal issues. Data shows users are up to 21% more likely to suffer a heart attack than non-users. The study does not confirm that PPIs cause heart attack, but researchers are concerned about the link, especially because people who use the medications might also already be dealing with heart issues. Those familiar with the study are urging patients using the medications to speak to their doctors about the risk.

Health experts would also like the US Food and Drug Administration to take note of the results from the study. Further research is needed to clarify the link between the medications and heart attacks, but the potential risk should not be overlooked or ignored. Many PPIs are now available over the counter, so their use is not as closely regulated as their prescription counterparts. Anyone taking the medications for more than two weeks needs to speak with their doctor immediately.

Despite not yet understanding what could cause the link, researchers theorized that PPIs might reduce the production of nitrous oxide from cells that line the heart and throughout the circulatory system. Decreased levels of nitric oxide have a long association with cardiac events.

Proton Pump Inhibitors among the Most Common Drugs Used throughout the World

Medications like Prilosec, Nexium, and Prevacid are some of the mostly widely used by people across the country and throughout the world. The Stanford study revealed approximately 113 million prescriptions are written annually and about 21 million people used one or more of the prescription versions of the medication by the year 2009. Estimates show total sales for PPIs including OTC versions are approximately $13 billion per year.

The study did not include data for patients using the OTC versions of the medication, which are typically smaller doses, but otherwise just the same.

How Do PPIs Work?

PPIs work by blocking acid from secreting into the stomach. This helps to ease heartburn caused by gastroesophogeal reflux disease. For years the medications have been considered safe and had relatively few side effects.

Heartburn medications including Zantac and Pepcid that came before PPIs work by blocking histamine production in the stomach. The study showed no link between heart attacks and either of these drugs.

Details of the Study

The Stanford study identified two groups within the data they viewed. One included 70,000 people and the other included 227,000 people, all of whom suffered from heartburn. Researchers compared the frequency of heart attacks among those who were using PPIs against those using other or no medications.

The researchers followed up by examining data on a group of more than 1500 patients who had experienced cardiac events to determine how many of them had been using PPIs. The study also revealed that for every 4,357 people who used PPIs for 14 days, there would be one additional heart attack among that group.

At this point, nobody in the medical community is concerned that risks might have been covered up during clinical trials of the medications. As a matter of fact, this is not the first time data mining has been used to reveal risks after the fact. Chances are researchers had no reason to believe there was a risk when PPIs were originally tested for market.

Source:

https://reference.medscape.com/drugs/proton-pump-inhibitors