Comparative effectiveness and safety of proton pump inhibitors after myocardial infarction on dual antiplatelet therapy: Insights from a target trial emulation - PubMed
6 hours ago
- #gastrointestinal bleeding
- #proton pump inhibitors
- #myocardial infarction
- Guidelines recommend PPIs with DAPT after MI to prevent GI bleeding, but PPIs may have different cardiovascular and bleeding effects.
- Study compared rabeprazole, pantoprazole, and lansoprazole in MI patients on DAPT using electronic health records, with GI bleeding as effectiveness outcome and composite CV events as safety outcome.
- Pantoprazole and lansoprazole had similar cardiovascular risk to rabeprazole, but pantoprazole was linked to higher recurrent MI risk.
- Lansoprazole showed lower GI bleeding risk compared to rabeprazole, with benefits increasing with higher baseline bleeding risk.
- Findings suggest similar cardiovascular safety among PPIs, but lansoprazole may offer better GI bleeding prevention, warranting external validation.