PDF(Pubmed)
Abstract：
UNASSIGNED: The objective of this research was to evaluate the risk of major adverse cardiovascular events (MACEs) associated with the use of various proton pump inhibitors (PPIs) in combination with clopidogrel in patients who underwent percutaneous coronary intervention (PCI).
UNASSIGNED: To accomplish this, we analyzed data from randomized controlled trials and retrospective cohort studies sourced from key electronic databases. These studies specifically examined the effects of different PPIs, such as lansoprazole, esomeprazole, omeprazole, rabeprazole, and pantoprazole, when used in conjunction with clopidogrel on MACEs. The primary focus was on the differential impact of these PPIs, while the secondary focus was on the comparison of gastrointestinal (GI) bleeding events in groups receiving different PPIs with clopidogrel vs. a placebo group. This study\'s protocol was officially registered with INPLASY (INPLASY2024-2-0009).
UNASSIGNED: We conducted a network meta-analysis involving 16 studies with a total of 145,999 patients. Our findings indicated that rabeprazole when combined with clopidogrel, had the lowest increase in MACE risk (effect size, 1.05, 95% CI: 0.66-1.66), while lansoprazole was associated with the highest risk increase (effect size, 1.48, 95% CI: 1.22-1.80). Esomeprazole (effect size, 1.28, 95% CI: 1.09-1.51), omeprazole (effect size, 1.23, 95% CI: 1.07-1.43), and pantoprazole (effect size, 1.38, 95% CI: 1.18-1.60) also significantly increased MACE risk. For the secondary outcome, esomeprazole (effect size, 0.30, 95% CI: 0.09-0.94), omeprazole (effect size, 0.34, 95% CI: 0.14-0.81), and pantoprazole (effect size, 0.33, 95% CI: 0.13-0.84) demonstrated an increased potential for GI bleeding prevention.
UNASSIGNED: In conclusion, the combination of lansoprazole and clopidogrel was found to significantly elevate the risk of MACEs without offering GI protection in post-PCI patients. This study is the first network meta-analysis to identify the most effective regimen for the concurrent use of clopidogrel with individual PPIs.
UNASSIGNED: https://inplasy.com/inplasy-2024-2-0009/, identifier (INPLASY2024-2-0009).
UNASSIGNED: To accomplish this, we analyzed data from randomized controlled trials and retrospective cohort studies sourced from key electronic databases. These studies specifically examined the effects of different PPIs, such as lansoprazole, esomeprazole, omeprazole, rabeprazole, and pantoprazole, when used in conjunction with clopidogrel on MACEs. The primary focus was on the differential impact of these PPIs, while the secondary focus was on the comparison of gastrointestinal (GI) bleeding events in groups receiving different PPIs with clopidogrel vs. a placebo group. This study\'s protocol was officially registered with INPLASY (INPLASY2024-2-0009).
UNASSIGNED: We conducted a network meta-analysis involving 16 studies with a total of 145,999 patients. Our findings indicated that rabeprazole when combined with clopidogrel, had the lowest increase in MACE risk (effect size, 1.05, 95% CI: 0.66-1.66), while lansoprazole was associated with the highest risk increase (effect size, 1.48, 95% CI: 1.22-1.80). Esomeprazole (effect size, 1.28, 95% CI: 1.09-1.51), omeprazole (effect size, 1.23, 95% CI: 1.07-1.43), and pantoprazole (effect size, 1.38, 95% CI: 1.18-1.60) also significantly increased MACE risk. For the secondary outcome, esomeprazole (effect size, 0.30, 95% CI: 0.09-0.94), omeprazole (effect size, 0.34, 95% CI: 0.14-0.81), and pantoprazole (effect size, 0.33, 95% CI: 0.13-0.84) demonstrated an increased potential for GI bleeding prevention.
UNASSIGNED: In conclusion, the combination of lansoprazole and clopidogrel was found to significantly elevate the risk of MACEs without offering GI protection in post-PCI patients. This study is the first network meta-analysis to identify the most effective regimen for the concurrent use of clopidogrel with individual PPIs.
UNASSIGNED: https://inplasy.com/inplasy-2024-2-0009/, identifier (INPLASY2024-2-0009).
摘要：
■本研究的目的是评估经皮冠状动脉介入治疗（PCI）患者中与各种质子泵抑制剂（PPI）联合使用氯吡格雷相关的主要不良心血管事件（MACE）的风险。
■要做到这一点，我们分析了来自关键电子数据库的随机对照试验和回顾性队列研究的数据.这些研究特别检查了不同PPI的影响，比如兰索拉唑,埃索美拉唑,奥美拉唑,雷贝拉唑,还有泮托拉唑,当在MACEs上与氯吡格雷联合使用时。主要关注这些PPI的不同影响，而次要重点是比较接受氯吡格雷与接受不同PPI组的胃肠道（GI）出血事件安慰剂组。本研究方案已在INPLASY（INPLASY2024-2-0009）正式注册。
■我们进行了一项网络荟萃分析，涉及16项研究，共145,999名患者。我们的研究结果表明，雷贝拉唑与氯吡格雷联合使用时，MACE风险增加最低(效应大小，1.05，95%CI：0.66-1.66），而兰索拉唑与最高风险增加相关(效应大小，1.48，95%CI：1.22-1.80）。埃索美拉唑（效应大小，1.28，95%CI：1.09-1.51），奥美拉唑(效应大小，1.23，95%CI：1.07-1.43），和泮托拉唑(效应大小，1.38，95%CI：1.18-1.60）也显著增加了MACE风险。对于次要结果，埃索美拉唑(效应大小，0.30，95%CI：0.09-0.94），奥美拉唑(效应大小，0.34，95%CI：0.14-0.81），和泮托拉唑(效应大小，0.33，95％CI：0.13-0.84）表明预防胃肠道出血的潜力增加。
■总而言之，研究发现,在PCI术后患者中,兰索拉唑和氯吡格雷的联合用药显著增加了MACE的风险,但未提供胃肠道保护.这项研究是第一个网络荟萃分析，以确定氯吡格雷与个体PPI同时使用的最有效方案。
■https://inplasy.com/inplasy-2024-2-0009/,标识符（INPLASY2024-2-0009）。
■要做到这一点，我们分析了来自关键电子数据库的随机对照试验和回顾性队列研究的数据.这些研究特别检查了不同PPI的影响，比如兰索拉唑,埃索美拉唑,奥美拉唑,雷贝拉唑,还有泮托拉唑,当在MACEs上与氯吡格雷联合使用时。主要关注这些PPI的不同影响，而次要重点是比较接受氯吡格雷与接受不同PPI组的胃肠道（GI）出血事件安慰剂组。本研究方案已在INPLASY（INPLASY2024-2-0009）正式注册。
■我们进行了一项网络荟萃分析，涉及16项研究，共145,999名患者。我们的研究结果表明，雷贝拉唑与氯吡格雷联合使用时，MACE风险增加最低(效应大小，1.05，95%CI：0.66-1.66），而兰索拉唑与最高风险增加相关(效应大小，1.48，95%CI：1.22-1.80）。埃索美拉唑（效应大小，1.28，95%CI：1.09-1.51），奥美拉唑(效应大小，1.23，95%CI：1.07-1.43），和泮托拉唑(效应大小，1.38，95%CI：1.18-1.60）也显著增加了MACE风险。对于次要结果，埃索美拉唑(效应大小，0.30，95%CI：0.09-0.94），奥美拉唑(效应大小，0.34，95%CI：0.14-0.81），和泮托拉唑(效应大小，0.33，95％CI：0.13-0.84）表明预防胃肠道出血的潜力增加。
■总而言之，研究发现,在PCI术后患者中,兰索拉唑和氯吡格雷的联合用药显著增加了MACE的风险,但未提供胃肠道保护.这项研究是第一个网络荟萃分析，以确定氯吡格雷与个体PPI同时使用的最有效方案。
■https://inplasy.com/inplasy-2024-2-0009/,标识符（INPLASY2024-2-0009）。
