The study’s findings lend support to an explanation for an untoward effect of PPIs on heart-disease risk proposed by Stanford scientists a few years ago. H2 blockers, which have been around longer than PPIs, are reasonably effective against heartburn and are the second-largest-selling class of drugs used to treat it. Interestingly, another commonly prescribed heartburn drug class called H2 blockers showed no association with elevated heart-attack risk. “These drugs may not be as safe as we think,” said Nicholas Leeper, MD, the study’s senior author and an assistant professor of vascular surgery and of cardiovascular medicine. However, the new study upends this view: It indicates that PPI use was associated with a roughly 20 percent increase in the rate of subsequent heart-attack risk among all adult PPI users, even when excluding those also taking clopidogrel.Ī paper describing the findings was published June 10 in PLOS ONE. More than 100 million prescriptions are filled every year in the United States for PPIs, a class of drugs long considered benign except for people concurrently taking the blood thinner clopidogrel (Plavix). But, he said, the study combed through electronic health records of nearly 3 million people and crunched trillions of pieces of medical data, raising concerns that should be taken seriously, especially now that PPIs are available over the counter. “The association we found with PPI use and increased chances of a subsequent heart attack doesn’t in and of itself prove causation,” said the study’s lead author, Nigam Shah, PhD, MBBS, an assistant professor of biomedical informatics and assistant director of the Stanford Center for Biomedical Informatics Research. In any given year, more than 20 million Americans - about one in every 14 - use PPIs such as omeprazole (trade name Prilosec) for heartburn, also known as acid reflux or gastroesophageal reflux disease. They are effective at lowering the acidity of the stomach, in turn preventing heartburn, a burning sensation in the chest that occurs when stomach acid rises up into the esophagus.
Proton-pump inhibitors, or PPIs, are among the world’s most widely prescribed drugs, with $14 billion in annual sales. A large data-mining study carried out by investigators at the Stanford University School of Medicine has linked a popular class of heartburn drugs to an elevated risk of heart attack.
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