Proton Pump Inhibitor Use and Risks of Cardiovascular Disease and Mortality in Patients With Type 2 Diabetes
Authors' conclusion
Our data suggest that PPI use is associated with higher risks of CVD events and mortality among patients with T2D. The benefits and risks of PPI use should be carefully balanced among patients with T2D, and monitoring of adverse CVD events during PPI therapy should be enhanced.
Study context
- Population
- Adults with T2D, UK Biobank
- Participants
- 19,229 adults
- Exposure
- PPI use vs no PPI use
- Outcome
- Risks of cardiovascular disease (CVD) (CAD, MI, HF, stroke) and all-cause mortality
- Follow-up
- Median 10.9 to 11.2 years
Methodological detailsUK Biobank
- UK Biobank
Main finding
As reported in the abstract
CAD, MI, HF, stroke and all-cause mortality with PPI use
- Coronary artery disease (CAD) with PPI use, HR
- 1.27 (1.15-1.40) (95% CI)
- Myocardial infarction (MI) with PPI use, HR
- 1.34 (1.18-1.52) (95% CI)
- Heart failure (HF) with PPI use, HR
- 1.35 (1.16-1.57) (95% CI)
- All-cause mortality with PPI use, HR
- 1.30 (1.16-1.45) (95% CI)
- Stroke with PPI use, HR (95% CI); no statistically significant association
- 1.11 (0.90-1.36)
Observational data: associations, not effects.
Further findings
Subgroup analyses (indications of PPI, antidiabetic medication use, antiplatelet drug use)
- Results consistent across subgroups
1:1 propensity score-matched cohort
- Similar results in PS-matched PPI users vs nonusers
- Propensity score-matched cohort
Original publication
Proton Pump Inhibitor Use and Risks of Cardiovascular Disease and Mortality in Patients With Type 2 Diabetes. J Clin Endocrinol Metab. Published 27 December 2022. doi:10.
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