Drugs in R&D ( IF 2.2 ) Pub Date : 2022-07-19 , DOI: 10.1007/s40268-022-00392-5 Hideki Arai 1, 2 , Shinichiro Ueda 3 , Kazutaka Uchida 1, 4 , Fumihiro Sakakibara 1, 4 , Norito Kinjo 1, 4 , Mari Nezu 1 , Takeshi Morimoto 1
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Purpose
Acid-suppressive drugs (ASDs) are often prescribed for patients with nonvalvular atrial fibrillation (NVAF) taking oral anticoagulants (OACs). However, the risk-benefit balance of ASDs prescription for patients with NVAF taking OACs is still unclear. This study aimed to assess the association between ASDs and clinical outcomes in patients taking OACs for NVAF.
Methods
This study is a subanalysis of an historical registry study from 71 centers in Japan. We included patients taking vitamin K antagonists for NVAF and excluded those with mechanical heart valves or a history of pulmonary thrombosis or deep vein thrombosis. We registered consecutive patients in February 2013 and followed them up until February 2017. The primary outcomes were ischemic events, major bleedings, and all-cause mortality. Ischemic stroke, acute myocardial infarction, and hemorrhagic stroke comprised the secondary outcomes.
Results
We included 7826 patients with a mean age of 73 years, 5274 (67%) of whom were males. The adjusted hazard ratios (95% confidence intervals) for ischemic events, major bleedings, and all-cause mortality in the ASD group compared with the no-ASD group were 0.998 (0.78–1.27), 0.98 (0.81–1.18), and 1.22 (1.02–1.47), respectively, while those for ischemic stroke, acute myocardial infarction, and hemorrhagic stroke were 0.96 (0.74–1.24), 0.82 (0.36–1.88), and 1.17 (0.69–1.99), respectively.
Conclusions
ASDs were significantly associated with all-cause mortality in patients with NVAF taking OACs.
中文翻译：
抑酸药物与非瓣膜性心房颤动患者临床结果之间的关联
目的
服用口服抗凝剂 (OAC) 的非瓣膜性心房颤动 (NVAF) 患者通常会服用抑酸药物 (ASD)。然而，对于服用 OAC 的 NVAF 患者，ASD 处方的风险与收益平衡仍不清楚。本研究旨在评估服用 OAC 治疗 NVAF 的 ASD 与临床结果之间的关联。
方法
本研究是对日本 71 个中心的历史登记研究的子分析。我们纳入了服用维生素 K 拮抗剂治疗 NVAF 的患者，并排除了那些有机械心脏瓣膜或有肺血栓形成或深静脉血栓形成史的患者。我们于 2013 年 2 月对连续患者进行了登记，并对他们进行随访直至 2017 年 2 月。主要结局是缺血事件、大出血和全因死亡率。次要结局包括缺血性中风、急性心肌梗死和出血性中风。
结果
我们纳入了 7826 名患者，平均年龄为 73 岁，其中 5274 名 (67%) 为男性。与非 ASD 组相比，ASD 组缺血事件、大出血和全因死亡率的调整后风险比（95% 置信区间）分别为 0.998 (0.78–1.27)、0.98 (0.81–1.18) 和 1.22分别为（1.02-1.47），而缺血性中风、急性心肌梗死和出血性中风分别为0.96（0.74-1.24）、0.82（0.36-1.88）和1.17（0.69-1.99）。
结论
ASD 与服用 OAC 的 NVAF 患者的全因死亡率显着相关。
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