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Proton pump inhibitors and the risk of severe adverse events : a cardiovascular bombshell?

dc.contributor.authorCunha, Nelson
dc.contributor.authorMachado, António Pedro
dc.date.accessioned2018-12-10T10:38:27Z
dc.date.available2018-12-10T10:38:27Z
dc.date.issued2018
dc.description© 2018 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. This is an Open Access article under the CC BY-NC-ND license.pt_PT
dc.description.abstractProton pump inhibitors are currently one of the most prescribed pharmacological classes in developed countries, given their effectiveness and safety profile, which has until now been considered favorable. However, in recent years, several papers have been published that associate prolonged use of these drugs with a wide range of adverse effects, posing doubts about their safety. Among the adverse effects described is an increased risk of cardiovascular events. This relationship was first described in subjects after acute coronary syndrome due to the interference of proton pump inhibitors in the cytochrome P450 2C19 and the conversion of clopidogrel to its active metabolite. More recent studies have also reported this relationship with the use of antiplatelet agents that do not depend on cytochrome P450 2C19 activation. The proposed mechanism is inhibition of dimethylarginine dimethylaminohydrolase, a physiological inhibitor of asymmetric dimethylarginine, which increases plasma concentrations of the latter enzyme, leading to lower levels of nitric oxide. By reviewing in this article the relationship between the use of proton pump inhibitors and increased risk of cardiovascular and cerebrovascular events, the authors aim to alert the medical community to the potentially harmful effects of these drugs, and recommend the setting of a moratorium on their prolonged use.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol. 2018;37(10):859-863pt_PT
dc.identifier.doi10.1016/j.repc.2017.10.012pt_PT
dc.identifier.issn2174-2049
dc.identifier.urihttp://hdl.handle.net/10451/35724
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier Españapt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/revista-portuguesa-de-cardiologia-english-editionpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectProton pump inhibitorspt_PT
dc.subjectNitric oxidept_PT
dc.subjectAcute coronary syndromept_PT
dc.subjectStrokept_PT
dc.titleProton pump inhibitors and the risk of severe adverse events : a cardiovascular bombshell?pt_PT
dc.title.alternativeInibidores da bomba de protões e o risco de eventos adversos graves : uma bomba cardiovascular?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage863pt_PT
oaire.citation.issue10pt_PT
oaire.citation.startPage859pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologia (English Edition)pt_PT
oaire.citation.volume37pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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