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.
Cross-Sectional (n=531)
No
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.
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.
Bai et al. (Wed,) conducted a cross-sectional in Acute coronary syndrome and atrial fibrillation (n=531). Proton pump inhibitors (PPIs) vs. No PPIs was evaluated on PPI administration at discharge. 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.