November 30, 2017
Findings from a new study by researchers at the UNC Gillings School of Global Public Health suggest that privately insured users of prescription proton pump inhibitors are no more likely to experience an acute myocardial infarction – commonly known as a heart attack – than those prescribed a similar medication: histamine-2-receptor antagonists.
Proton pump inhibitors (PPIs) are medications commonly used for conditions like acid reflux. Recent studies reported finding an increased risk of heart attack among PPI users compared with non-users. Because PPI use is so widespread, these alarming reports had important implications for physicians and their patients.
To investigate the association, researchers led by Suzanne Landi, MPH, a doctoral student of epidemiology at the Gillings School, conducted a study comparing heart attack risk in PPI users to risk in users of a similar medication, histamine-2-receptor antagonists (H2RAs).
The researchers evaluated data from employer-based insurance claims databases from 2002 to 2014, including claims from commercial and Medicare Supplemental plans. They followed patients from the first PPI or H2RA prescription, noting any hospitalizations for myocardial infarction and using a propensity-matching method to reduce confounding.
“We analyzed information from more than 5 million privately insured adults in the United States,” said Landi. “We did not observe an increase in myocardial infarction risk associated with PPIs compared with H2RAs, leading us to suggest that physicians and patients should not avoid starting a PPI because of concerns related to heart attack risk.”
The full article on these findings, titled “No Increase in Risk of Acute Myocardial Infarction in Privately Insured Adults Prescribed Proton Pump Inhibitors vs Histamine-2 Receptor Antagonists (2002-2014),” was published online Nov. 6 by Gastroenterology. Other co-authors from the Gillings School included Robert Sandler, MD, professor, Jennifer Lund, PhD, assistant professor, and Virginia Pate, MS, applications analyst, all in the Department of Epidemiology.