Abstract 11677: Associations Between Proton Pump Inhibitors and Low Cardiac Mortality in Patients With Heart Failure
Background: It has been recently reported that use of histamine H2 receptor blocker (H2RA) is associated with the blockade of right and left ventricular remodeling and reduces risk of incident heart failure (HF) in cohort of participants without cardiovascular diseases. However, the association between acid suppressive therapy such as H2RA or proton pump inhibitor (PPI) and cardiac mortality in HF patients is still unclear. Therefore, we examined impacts of the acid suppressive therapy on cardiac mortality in HF patients.
Methods and Results: We analyzed consecutive 1191 HF patients. These patients were divided into 3 groups: no acid suppressive therapy group (None, n = 363), H2RA group (n = 164) and PPI group (n = 664). Although presence of male gender, diabetes, atrial fibrillation and reduced left ventricular ejection fraction did not differ among the three groups, prevalence of ischemic etiology, dyslipidemia, chronic kidney disease, anemia and past history of peptic ulcer was higher in PPI group than in H2RA and no acid suppressive therapy groups (ischemic etiology 32.2% vs. 27.4% and 15.7%, p<0.001; dyslipidemia 79.2% vs. 77.4% and 70.5%, p=0.007; chronic kidney disease 62.8% vs. 57.3% and 53.2%, p=0.010; anemia 64.0% vs. 54.3% and 46.0%, p<0.001; peptic ulcer 15.1% vs. 7.9% and 6.3%, p<0.001). In the follow-up period (mean 995 days), 169 cardiac deaths occurred. In the Kaplan-Meier analysis, cardiac mortality was significantly lower in PPI group than in H2RA and no acid suppressive therapy groups (11.0% vs. 21.3% and 16.8%, respectively, p<0.05). In the multivariable Cox proportional hazard analysis after adjusting for other potential confounding factors, use of PPI, but not H2RA, was an independent predictor of cardiac mortality in HF patients (PPI, HR 0.475, P<0.001 and H2RA, HR 0.968, P=0.881).
Conclusion: Proton pump inhibitors may be associated with better outcome in patients with heart failure.
Author Disclosures: M. Takiguchi: None. A. Yoshihisa: None. Y. Sato: None. S. Watanabe: None. T. Yokokawa: None. S. Miura: None. T. Sato: None. S. Suzuki: None. M. Oikawa: None. A. Kobayashi: None. T. Yamaki: None. H. Kunii: None. S. Saitoh: None. Y. Takeishi: None.
- © 2016 by American Heart Association, Inc.