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Date of download: 9/19/2016 From: Proton-Pump Inhibitors Are Associated With Increased Cardiovascular Risk Independent of Clopidogrel Use: A Nationwide.

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Presentation on theme: "Date of download: 9/19/2016 From: Proton-Pump Inhibitors Are Associated With Increased Cardiovascular Risk Independent of Clopidogrel Use: A Nationwide."— Presentation transcript:

1 Date of download: 9/19/2016 From: Proton-Pump Inhibitors Are Associated With Increased Cardiovascular Risk Independent of Clopidogrel Use: A Nationwide Cohort Study Ann Intern Med. 2010;153(6):378-386. doi:10.7326/0003-4819-153-6-201009210-00005 Cumulative claimed prescriptions for clopidogrel after discharge for first myocardial infarction. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

2 Date of download: 9/19/2016 From: Proton-Pump Inhibitors Are Associated With Increased Cardiovascular Risk Independent of Clopidogrel Use: A Nationwide Cohort Study Ann Intern Med. 2010;153(6):378-386. doi:10.7326/0003-4819-153-6-201009210-00005 Study flow diagram.MI = myocardial infarction; PPI = proton-pump inhibitor. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

3 Date of download: 9/19/2016 From: Proton-Pump Inhibitors Are Associated With Increased Cardiovascular Risk Independent of Clopidogrel Use: A Nationwide Cohort Study Ann Intern Med. 2010;153(6):378-386. doi:10.7326/0003-4819-153-6-201009210-00005 Distribution of probabilities of treatment with PPIs in propensity score–matched analysis.PPI = proton-pump inhibitor. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

4 Date of download: 9/19/2016 From: Proton-Pump Inhibitors Are Associated With Increased Cardiovascular Risk Independent of Clopidogrel Use: A Nationwide Cohort Study Ann Intern Med. 2010;153(6):378-386. doi:10.7326/0003-4819-153-6-201009210-00005 Propensity score–matched Kaplan–Meier analysis of risk for cardiovascular death, myocardial infarction, or stroke.PPI = proton-pump inhibitor. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

5 Date of download: 9/19/2016 From: Proton-Pump Inhibitors Are Associated With Increased Cardiovascular Risk Independent of Clopidogrel Use: A Nationwide Cohort Study Ann Intern Med. 2010;153(6):378-386. doi:10.7326/0003-4819-153-6-201009210-00005 Propensity score–matched Kaplan–Meier estimates of cardiovascular death, myocardial infarction, or stroke for subtypes of PPIs.PPI = proton-pump inhibitor. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

6 Date of download: 9/19/2016 From: Proton-Pump Inhibitors Are Associated With Increased Cardiovascular Risk Independent of Clopidogrel Use: A Nationwide Cohort Study Ann Intern Med. 2010;153(6):378-386. doi:10.7326/0003-4819-153-6-201009210-00005 Risk for cardiovascular death, myocardial infarction, or stroke for subtypes of PPIs.Time-dependent, propensity score–matched Cox proportional hazards analysis. PPI = proton-pump inhibitor. * Used as reference. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

7 Date of download: 9/19/2016 From: Proton-Pump Inhibitors Are Associated With Increased Cardiovascular Risk Independent of Clopidogrel Use: A Nationwide Cohort Study Ann Intern Med. 2010;153(6):378-386. doi:10.7326/0003-4819-153-6-201009210-00005 Required size for an unmeasured confounder.Size needed to account for the elevation of risk from 1 to 1.29. OR EC = association between drug use category and confounder; RR CD = association between confounder and disease outcome. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

8 Date of download: 9/19/2016 From: Proton-Pump Inhibitors Are Associated With Increased Cardiovascular Risk Independent of Clopidogrel Use: A Nationwide Cohort Study Ann Intern Med. 2010;153(6):378-386. doi:10.7326/0003-4819-153-6-201009210-00005 Hazard ratio for cardiovascular death, myocardial infarction, or stroke in subgroups treated with PPIs.Time-dependent, propensity score–matched Cox proportional hazards analysis. Diabetes was defined as requiring glucose-lowering medication. PCI = percutaneous coronary intervention; PPI = proton-pump inhibitor. * Used as reference. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

9 Date of download: 9/19/2016 From: Proton-Pump Inhibitors Are Associated With Increased Cardiovascular Risk Independent of Clopidogrel Use: A Nationwide Cohort Study Ann Intern Med. 2010;153(6):378-386. doi:10.7326/0003-4819-153-6-201009210-00005 Clopidogrel and PPI therapy, by individual participating hospital.Proportion of patients, by individual hospital, who received clopidogrel (top) or a PPI (bottom) within 1 year of discharge after a myocardial infarction. Outliers are small hospitals with few patients. PPI = proton-pump inhibitor. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

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