In a large, randomized control trial use of protons was not linked to any adverse events, other than slightly high risk of enteric infection. About 17,000 patients were enrolled and the study continued for 3 years.

These patients had cardiovascular disease (stable) and were either on aspirin, or anticoagulation like Xarelto.

Of note, there were 13 reported cases of Clostridium Difficile (CDI) infection, which was twice higher than the group which was not on PPI. Otherwise no other adverse events were noted.

Take Home Messages :

Take Home messages

  1. PPIs use in patients with cardiovascular disease did not lead to any increased risk of cardiac events
  2. Only 13 cases of CDI were reported. It would be interesting to find out if patients were on probiotics and if use of probiotics with PPI would decrease incidence of PPI.

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