Clinical events as a function of proton pump inhibitor use, @entity1397 use, and @entity4433 genotype in a large nationwide cohort of acute @entity583 : results from the French Registry of Acute ST-Elevation and Non-ST-Elevation XXXX (FAST-MI) registry.

@entity1 @entity64 @entity548 @entity4433 @entity1397 @entity583 @entity204 @entity360
BACKGROUND: @entity1397 requires metabolic activation by @entity4433 ( @entity4433 ). Proton pump inhibitors (PPIs) that inhibit @entity4433 are commonly coadministered with @entity1397 to reduce the risk of @entity360 . This analysis compares treatment outcomes for @entity1 in the French Registry of Acute ST-Elevation and Non-ST-Elevation @entity583 (FAST-MI) who did or did not receive @entity1397 and/or PPIs. METHODS AND RESULTS: The FAST-MI registry included 3670 @entity1 (2744 @entity1397 - and PPI-na  ve @entity1 ) presenting with definite MI. @entity1 were categorized according to use of @entity1397 and/or PPI within 48 hours after hospital admission. PPI use was not associated with an increased risk for any of the main in-hospital events (in-hospital survival, reinfarction, @entity64 , @entity548 , and transfusion). Likewise, PPI treatment was not an independent predictor of 1-year survival (hazard ratio, 0.97; 95% confidence interval [CI], 0.87 to 1.08; P=0.57) or 1-year MI, @entity64 , or @entity204 (hazard ratio, 0.98; 95% CI, 0.90 to 1.08; P=0.72). No differences were seen when the type of PPI or @entity4433 genotype was taken into account. In the propensity-matched cohorts, the odds ratios for major in-hospital events in PPI versus no PPI were 0.29 (95% CI, 0.06 to 1.44) and 1.70 (95% CI, 0.10 to 30.3) for @entity1 with 1 and 2 variant alleles, respectively. Similarly, the hazard ratio for 1-year events in hospital survivors was 0.68 (95% CI, 0.26 to 1.79) and 0.55 (95% CI, 0.06 to 5.30), respectively. CONCLUSION: PPI use was not associated with an increased risk of cardiovascular events or mortality in @entity1 administered @entity1397 for recent MI, whatever the @entity4433 genotype, although harm could not be formally excluded in @entity1 with 2 loss-of-function alleles.
