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Individualized prevention of proton pump inhibitor related adverse events by risk stratification

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机构: [1]Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China. [2]Chinese Health RIsk MAnagement Collaboration (CHRIMAC), Shenzhen, Guangdong, China. [3]Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK. [4]University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. [5]Institute of Cancer andGenomic Sciences, University of Birmingham, Birmingham, UK. [6]College of Medical and Dental Sciences, Centre for Health Data Science, University of Birmingham, Edgbaston, Birmingham, UK. [7]Institute of Applied Health Research, University of Birmingham, Birmingham, UK. [8]Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China. [9]Oxford Population Health, University of Oxford, Oxford, Oxfordshire, UK. [10]Division of Gastroenterology, Davis School of Medicine, University of California, Oakland, CA, USA. [11]National Clinical Research Center forGeriatrics and Department of General Practice, West ChinaHospital, Sichuan University, Chengdu, China. [12]J.C. School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China. [13]Department of Surgery, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China. [14]Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China. [15]School of Population and Global Health, Faculty of Medicine, Density and Health Sciences, University of Western Australia, Perth, AU-WA, Australia. [16]Laboratory of Data Discovery for Health (D24H), Hong Kong Science Technology Park, Sha Tin, Hong Kong, China
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Proton pump inhibitors (PPIs) are commonly used for gastric acid-related disorders, but their safety profile and risk stratification for high-burden diseases need further investigation. Analyzing over 2 million participants from five prospective cohorts from the US, the UK, and China, we found that PPI use correlated with increased risk of 15 leading global diseases, such as ischemic heart disease, diabetes, respiratory infections, and chronic kidney disease. These associations showed dose-response relationships and consistency across different PPI types. PPI-related absolute risks increased with baseline risks, with approximately 82% of cases occurring in those at the upper 40% of the baseline predicted risk, and only 11.5% of cases occurring in individuals at the lower 50% of the baseline risk. While statistical association does not necessarily imply causation, its potential safety concerns suggest that personalized use of PPIs through risk stratification might guide appropriate decision-making for patients, clinicians, and the public.© 2024. The Author(s).

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大类 | 1 区 综合性期刊
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Q1 MULTIDISCIPLINARY SCIENCES
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Q1 MULTIDISCIPLINARY SCIENCES

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第一作者机构: [1]Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China. [2]Chinese Health RIsk MAnagement Collaboration (CHRIMAC), Shenzhen, Guangdong, China.
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通讯机构: [1]Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China. [2]Chinese Health RIsk MAnagement Collaboration (CHRIMAC), Shenzhen, Guangdong, China. [8]Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China. [15]School of Population and Global Health, Faculty of Medicine, Density and Health Sciences, University of Western Australia, Perth, AU-WA, Australia. [16]Laboratory of Data Discovery for Health (D24H), Hong Kong Science Technology Park, Sha Tin, Hong Kong, China
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