In Brief: Stanford Links Reflux Medicine To Heart Attack Risk; COPE Launches Care Coordination Effort

Stanford Links Reflux Medicine To Greater Heart Attack Risk

A new study by the Stanford University School of Medicine has linked the use of a popular medication to control acid reflux with a greater risk of heart attacks.

The study examined the use of proton pump inhibitors (PPIs), which are sold by prescription and over the counter under the brand names Prilosec and Nexium and are used by an estimated 20 million Americans.

Researchers sifted through 3 million de-identified patient medical records for the study. They discovered an elevated heart attack risk ranging from 16% to 20% among patients who had been taking PPIs.

“These drugs may not be as safe as we think,” said Nicholas Leeper, M.D., the study’s senior author and a Stanford assistant professor of vascular surgery and cardiovascular medicine.

Another reflux medication known as H2 blockers was also examined in the study and not associated with an elevated heart attack risk.

Leeper noted prior studies had indicated a connection between the use of PPIs and a decrease of levels of nitric oxide in patients, which could lead to blood vessel constriction and heart attacks. An ongoing longitudinal study being conducted by Stanford and Mount Sinai Medical Center in New York City also showed an increase risk of adverse cardiac events among patients who use PPIs. 

Although Leeper himself recently conducted a small pilot study that showed a link between PPIs and diminished nitric oxide levels, he said the sample was not large enough to be conclusive.

“This association needs to be tested in a large, prospective, randomized trial,” he said. “The truth will come out when we randomize several hundred people, give half of them PPIs and put the other half on H2 blockers, and see what happens.”

COPE Launches Coordinated Care Effort

Los Angeles-based COPE Health Solutions has launched a service line that will focus on care coordination.

The practice of carefully coordinating care for patients between inpatient and post-discharge care has been linked to dramatic reductions in costs and fewer readmissions to hospitals after discharge.

Along with providing planning and modeling to clients for care coordination programs, COPE officials said they would train what are known as “certified care navigators” to help provide a continuum of coordinated care for patients at hospitals. The training would come in part through COPE’s existing health scholars program, which prepares college students for careers in healthcare or to pursue post-garduate degrees in the field.

“Health systems--who have achieved remarkable success by employing case managers to identify opportunities, make connections, close gaps and troubleshoot issues--do not have nearly enough people to carry out all of these tasks, in California or anywhere else,” said COPE Execuitve Vice President Cindy Ehnes, who is overseeing the care coordination effort. “Certified care navigators help fill this acute need.”