Patients suffering from coronary artery disease (CAD) might want to think twice about taking proton pump inhibitors. A new study suggests that the popular heartburn drugs could increase the risk of heart failure and death in these individuals.
Many patients with CAD take heartburn medications to combat the gastrointestinal side effects of chronic antiplatelet therapy. However, data already suggests that drugs in the proton pump inhibitor class could inhibit the efficacy of Plavix and aspirin, leading to more cardiovascular events in these individuals. For this new study, researchers writing in PLoS One analyzed data on 706 CAD patients, 431 of whom were taking Prilosec. The study’s primary outcome was a combination of secondary outcomes, which included 1) any acute ischemic events (such as acute coronary syndrome, stroke, or transient ischemic attack) and 2) heart failure (HF) or death.
“Follow-up was 2.2±0.99 years. Seventy-eight patients met the primary outcome, 53 developed acute ischemic events, and 33 HF or death,” the authors of the paper wrote. “PPI use was an independent predictor of the primary outcome [hazard ratio (HR) = 2.281 (1.244–4.183); p = 0.008], along with hypertension, body-mass index, glomerular filtration rate, atrial fibrillation, and nitrate use. PPI use was also an independent predictor of HF/death [HR = 5.713 (1.628–20.043); p = 0.007], but not of acute ischemic events. A propensity score showed similar results.”
Proton pump inhibitors, including Nexium, Prilosec and PrevAcid, are approved for the short-term treatment of GERD and other peptic disorders. In 2013, more than 15 million Americans used prescription drugs in this class, at a cost of more than $10 billion. However, some research has suggested that these drugs are being overused. Studies have also linked their long-term use to an increased risk of dementia, B12 deficiency, low magnesium levels, heart attacks and serious kidney complications, including chronic kidney disease and renal failure.
Numerous proton pump inhibitor users who went on to develop kidney ailments have filed lawsuits in an attempt to obtain compensation for their pain and suffering. These plaintiffs claim that the drugs’ manufacturers have been aware for years that these medications could potentially harm the kidneys, yet failed to issue appropriate warnings to doctors and patients. Plaintiffs further assert that they could have avoided their kidney problems had they received proper notice of these risks.
Last month, the U.S. Judicial Panel on Multidistrict Litigation (JPML) denied a petition to centralize all such federal lawsuits in a single U.S. District Court. However, the litigation involving proton pump inhibitors and serious kidney problems continues to grow, and for now cases will progress through courts on an individual basis.