engleski

Connections of nutritional status and proton pump inhibitor therapy in patients scheduled for cardiovascular rehabilitation after treatment for ischemic and valvular heart disease.

BACKGROUND AND AIM: Multiple and yet uncertain connection exists between cardiovascular diseases and nutritional status of patients, particularly in relation with cardiovascular treatments. Proton pump inhibitors(PPI) are among the most commonly used group of drugs. Objective of our study was to analyze utilization of PPI in association with nutritional risk of patients scheduled for rehabilitation after treatment for ischemic and valvular heart disease. METHODS: Retrospective analyzes on consecutive sample of patients that included drug utilization of PPI and nutritional risk screening, using standardized NRS-2002 tool. Patients(N=536) were divided in groups based on previous cardiovascular treatments and use of PPI. RESULTS: Nearly half of patients, 244(46.1%) had proton pump inhibitor in their chronic therapy, despite the clinically negligible prevalence of conditions which are their fundamental indications. Odds for using PPI in patients with increased nutritional risk, estimated by logistic regression were 3.34[95%-confidence intervals(CI): 2.26-4.94], p<0.001. Receiver operating curve analyzes also revealed significant differences of PPI utilization in connection with NRS-2002>3: positive likelihood-ratio(LR):2.35[95%CI:2.10- 2.60] ; negative-LR:0.46[95%CI:0.4-0.6] ; AUC 0.720 ; p<0.001 ; as well as the percentage weigh loss history >6.36%(positive LR:2.22 [95%CI:2.00- 2.50] ; negative LR:0.41[95%CI: 0.30-0.50] ; AUC 0.707 ; p<0.001. CONCLUSIONS: Utilization of PPI was found to be of relatively high prevalence and significantly associated with parameters of nutritional risk screening. Furthermore, it was in correlation with age of patients and existence of chronic kidney disease, which are well-established predispositions for poor nutritional status. Nutritional risk seems to be additionally negatively challenged by utilization of PPI due to gastric malabsorption and anemia.

schemic heart disease ; nutritional risk ; nutritional status ; proton pump inhibitors (PPI) ; valvular heart disease

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