Study Questions Use of PPI for Atrial Fibrillation
Patients hospitalized with atrial fibrillation (AF) who were treated with proton pump inhibitors (PPIs) had an increased risk for re-hospitalization with heart failure within 12 months after discharge, according to the results of a new study.
The retrospective study included 172 patients with AF who were successfully discharged from the hospital (mean age 69.2 years, 37.2% male). Researchers obtained hematocrit (Htc) nadir values during patients’ in-hospital stay, and determined the proportion of PPI prescriptions filled at discharge. The primary outcome was incidence of hospitalization for new acute heart failure (AHF) 12 months after discharge.
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Overall, 53 patients (30.8% ) had a PPI prescription at discharge, which was prescribed during in-hospital stay. Those who received PPI therapy had significantly lower Nadi Htc during hospitalization.
Patients with AF who received PPIs had higher incidence of AF within the 12 months after discharge compared to patients who did not receive PPI therapy. PPI therapy was found to be an independent predictor of AHF after researchers adjusted for age and chronic kidney disease.
“Approximately one-third of the AF patients were treated with PPI, the vast majority without formal indication,” the researchers concluded. “PPI overuse was associated with anemia and hospitalization for de novo acute heart failure and therefore its use must be carefully weighted in clinical practice.”
—Melissa Weiss
Reference:
Augusto JB, Borges Dos Santos M, Roque D, et al. Utilization of proton pump inhibitors in patients with atrial fibrillation is associated with hospitalization for de novo acute heart failure. Presented at: European Society of Cardiology 4th World Congress on Heart Failure 2017; April 29-May 2, 2017; Paris, France. Abstract 2066.