Proton Pump Inhibitors linked to substantial risk of CVD and mortality among T2 Diabetics

China: Researchers from Wuhan, China found that proton pump inhibitors are associated with a greater risk of cardiovascular disease and mortality among patients with type 2 diabetes. The study results were published in The Journal of Clinical Endocrinology & Metabolism. 

Diabetes is a global pandemic and is at an increased risk of morbidity and mortality. Proton pump inhibitors (PPIs) are largely used for gastric-acid-related diseases, that can affect the gut microbiome. Recent data suggest that PPIs use can cause cardiovascular diseases and increase mortality in T2 diabetics. Hence, Tingting Geng et al from Wuhan, China evaluated the associations of PPI use with cardiovascular disease (CVD) risks and all-cause mortality in patients with type 2 diabetes (T2D). 

Using data from the UK Biobank study, the associations of PPI use with risks of coronary artery disease (CAD), myocardial infarction (MI), heart failure (HF), stroke, and all-cause mortality were evaluated in 19,229 adults with T2D. 

Key findings of the study: 

• During a median follow-up of 10.9-11.2 years, a total of 2,971 CAD, 1,827 MI, 1,192 HF, and 738 stroke cases, along with 2,297 total deaths were documented.
• There was a significant association with higher risks of CAD, MI, HF, and all-cause mortality with PPI use.
• PPI use was not significantly associated with stroke.
• Subgroup analyses revealed consistent results stratified by factors including indications of PPI, anti-diabetic medication use, and antiplatelet drug use. 
• Similar results were obtained in the analyses in a 1:1 propensity score-matched cohort of PPI users versus non-users. 

Thus, the study indicates a higher risk of CVD and mortality with the use of PPIs in type 2 Diabetics. 

Further reading: Geng T, Chen JX, Zhou YF, et al. Proton Pump Inhibitor Use and Risks of Cardiovascular Disease and Mortality in Patients with Type 2 Diabetes [published online ahead of print, 2022 Dec 27]. J Clin Endocrinol Metab. 2022;dgac750. doi: 10.1210/clinem/dgac750