Lin Ming-Hsun, Wu Wen-Tung, Chen Yong-Chen, Chien Wu-Chien, Lin Tsung-Kun, Chou Yu-Ching, Hsu Po-Shun, Sun Chien-An
Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Department of Pharmacy, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Cardiovasc Drugs Ther. 2024 Dec 13. doi: 10.1007/s10557-024-07643-4.
Proton pump inhibitors (PPIs) are widely prescribed for gastrointestinal disorders. Lansoprazole, a PPI, has been recognized for its potential effects of improving insulin resistance, reduction of oxidative stress, and improvement in atherosclerosis through peroxisome proliferator-activated receptor gamma (PPARγ) induction. This study aims to investigate whether lansoprazole poses a distinct risk of coronary heart disease (CHD) compared to other PPIs.
A retrospective cohort study utilized data from the National Health Insurance Research Database in Taiwan spanning from 2000 to 2013. The exposed cohort included 1666 patients with lansoprazole use, while the comparison cohort comprised 6664 patients using other PPIs. The primary outcome was incident CHD. Cox regression models were employed to assess the association between lansoprazole use and CHD risk, presenting hazard ratios (HRs) and 95% confidence intervals (CIs).
Patients prescribed lansoprazole demonstrated a significantly reduced risk of CHD compared to those undergoing other PPI treatments in individuals without a history of CHD. Lansoprazole users exhibited a 25% lower risk of developing CHD compared to other PPI users (adjusted HR 0.75; 95% CI 0.65-0.87). Intriguingly, this inverse association between lansoprazole use and CHD risk was consistent across genders and various age groups.
This study suggests that lansoprazole is associated with a decreased risk of CHD in comparison to other PPIs in patients without a history of CHD. Further research is warranted to elucidate the clinical implications of these findings.
质子泵抑制剂（PPIs）被广泛用于治疗胃肠道疾病。兰索拉唑作为一种PPI，因其通过诱导过氧化物酶体增殖物激活受体γ（PPARγ）改善胰岛素抵抗、降低氧化应激以及改善动脉粥样硬化的潜在作用而受到认可。本研究旨在调查与其他PPIs相比，兰索拉唑是否会带来独特的冠心病（CHD）风险。
一项回顾性队列研究利用了台湾国民健康保险研究数据库2000年至2013年的数据。暴露队列包括1666名使用兰索拉唑的患者，而对照队列包括6664名使用其他PPIs的患者。主要结局是冠心病的发病情况。采用Cox回归模型评估使用兰索拉唑与冠心病风险之间的关联，给出风险比（HRs）和95%置信区间（CIs）。
在无冠心病病史的个体中，与接受其他PPI治疗的患者相比，使用兰索拉唑的患者患冠心病的风险显著降低。与其他PPI使用者相比，使用兰索拉唑的患者患冠心病的风险低25%（调整后的HR为0.75；95%CI为0.65 - 0.87）。有趣的是，使用兰索拉唑与冠心病风险之间的这种负相关在不同性别和各年龄组中都是一致的。
本研究表明，在无冠心病病史的患者中，与其他PPIs相比，兰索拉唑与降低冠心病风险相关。有必要进一步研究以阐明这些发现的临床意义。
