What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Acute coronary syndrome and atrial fibrillation (n=531). Intervention: Proton pump inhibitors (PPIs) vs. No PPIs. Primary outcome: PPI administration at discharge.

What question did this study set out to answer?

This study analyzes the usage patterns and influencing factors of proton pump inhibitors in patients with acute coronary syndrome and atrial fibrillation.

April 19, 2026Open Access

Current status of proton pump inhibitor usage in patients with acute coronary syndrome and atrial fibrillation: a cross-sectional study

Q: What does this research mean for the field?

Proton pump inhibitors are prescribed to approximately 48% of patients with acute coronary syndrome and atrial fibrillation at discharge, with usage increasing significantly from 2010 to 2018. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

YBYing BaiBeijing Tongren Hospital JWJianqi WangBeijing Tongren Hospital GLGuangyao LiBeijing Tongren Hospital

Key Result

Proton pump inhibitors were prescribed to 47.8% of patients with acute coronary syndrome and atrial fibrillation at discharge, with usage increasing significantly from 21.3% in 2010-2012 to 63.5% in 2016-2018.

Key Points

This study analyzes the usage patterns and influencing factors of proton pump inhibitors in patients with acute coronary syndrome and atrial fibrillation.
Cross-sectional design
Single-center data from Beijing Tongren Hospital (2010-2018)
Categorized patients into PPI and non-PPI groups
Analyzed factors influencing PPI administration at discharge
Among 531 patients, 47.8% were prescribed PPIs at discharge.
PPI usage increased from 21.3% (2010-2012) to 63.5% (2016-2018).
Patients receiving PPIs had higher odds of having non-ST elevation myocardial infarction and ST elevation myocardial infarction.
Those on PPIs were more likely to receive catheter ablation and anticoagulants compared to non-PPI patients.

Study Design

Type

Cross-Sectional (n=531)

Multicenter

Structured PICO

Population

531 patients diagnosed with acute coronary syndrome (ACS) and atrial fibrillation (AF) hospitalized at a single center in Beijing, China, from January 2010 to December 2018. Median age 73 years, 61.4% male.

Intervention

Proton pump inhibitor (PPI) administration at discharge

Comparator

No proton pump inhibitor (PPI) administration at discharge

Outcome

Prescription pattern, trends, and factors influencing PPI use at discharge

Approximately half of Chinese patients with ACS and AF are prescribed PPIs at discharge, with usage increasing over time and strongly associated with OAC use, GI disorders, and specific ACS/AF types.

Limitations

Single-center study at a tertiary care hospital, limiting generalizability to other settings or countries
Retrospective design with exclusions due to incomplete information or death, potentially leading to selection bias
Did not assess the appropriateness of PPI prescriptions
Lack of follow-up data restricts the generalizability of the conclusions

Abstract

Background The real-world status of proton pump inhibitor (PPI) administration in patients with acute coronary syndrome (ACS) and atrial fibrillation (AF) remains largely unknown. Objectives This study aimed to analyze the prescription pattern, trends and influencing factors of PPIs among Chinese patients with ACS and AF at discharge. Methods This single-center, retrospective, cross-sectional study included patients with ACS and AF who were hospitalized at the Cardiovascular Center of Beijing Tongren Hospital from January 2010 to December 2018. All patients were subsequently categorized into two groups based on PPI administration at discharge (i.e., the PPI and non-PPI group), after which factors influencing PPI use were analyzed. Results This study included 531 patients diagnosed with ACS and AF, with a median age of 73 years, 61.4% of these patients were male. Among them, 254 patients (47.8%) were administered PPIs. A significant increasing trend in PPI administration was observed from 21.3% (2010–2012) to 63.5% (2016–2018) ( p 0.001). Patients receiving PPIs were more likely to have non-ST-segment elevation myocardial infarction (UNSTEMI) adjusted odds ratio (OR) 3.358, 95% confidence interval (CI) 1.819–6.196, p 0.001, ST-elevation myocardial infarction (STEMI) adjusted OR 4.092, 95% CI 2.177–7.694, p 0.001, paroxysmal AF adjusted OR 1.732, 95% CI 1.022–2.936, p = 0.041, GI disorders adjusted OR 17.625, 95% CI 9.783–31.751, p 0.001, were more likely to undergo catheter ablation adjusted OR 13.368, 95% CI 3.836–46.586, p 0.001 and more likely to receive oral anticoagulants adjusted OR 1.918, 95% CI 1.006–3.658, p = 0.048 compared to those not receiving PPIs. Conclusions Our findings revealed that approximately 50% of patients with AF and ACS were prescribed PPI at discharge, highlighting the need to carefully evaluate the risks and benefits of combining antithrombotic medications and PPIs on an individual basis.

KI fragen

Bookmark

View Full Paper