Journal of Kerman University of Medical Sciences

The Effect of Proton-Pump Inhibitors the on Development of Arrhythmia and Hypomagnesemia After Off-Pump Coronary Artery Bypass Surgery

Document Type : Original Article

Authors

Hasan Abbaspour 1
Arash Peivandi Yazdi 1
Seyed Javad Purafzali Firuzabadi 2
Vida Vakili 3
Mohamad Abbasi Tashnizi 4
Shahram Amini 5

1 Department of Anesthesiology and Critical Care, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Anesthesiology and Critical Care and Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Family Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Department of Cardiac Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Department of Anesthesiology and Critical Care, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

https://doi.org/10.34172/jkmu.2023.58
Abstract
 
 Background: Long-term use of proton-pump inhibitors (PPI) can result in hypomagnesemia and arrhythmia. This study aimed to compare the effect of PPI and histamine 2-receptor antagonists (H2RA) on the incidence of hypomagnesemia and arrhythmia in patients following off-pump coronary artery bypass surgery (CABG).
Method: In this randomized-controlled clinical trial 290 patients admitted to the ICU after off-pump CABG were randomly divided into two groups of H2RA (n = 145) and PPI (n = 145). For patients in the H2RA group, 50 mg intravenous ranitidine was prescribed every 8 hours after the nothing by mouth (NPO) period, followed by 40 mg famotidine tablets after starting the oral regimen (PO). The PPI group received 40 mg pantozol IV injections every 12 hours during the NPO period and 40 mg pantozol tablets once daily after becoming PO. The patients were investigated for the development of hypomagnesemia and associated arrhythmia.
Results: In total 271 patients with a mean age of 59.3 ± 10 years completed the study (female/male = 32.8%). Hypomagnesemia occurred in 60.1% of the patients, 76 (56.7%) in the H2RA group and 87 (63.5%) in the PPI group (P = 0.245), whereas arrhythmia had a prevalence of 12 (9.6%) and 15 (11.1%) cases, respectively (P = 0.690). The mean time of occurrence of hypomagnesemia and arrhythmia was 1.75 ± 1.08 and 3.0 ± 0.9 days after the operation in the H2RA group (P = 0.111) and 1.47 ± 0.7 and 2.9 ± 1.5 days in the PPI group (P = 0.897), respectively.
Conclusion: Our study revealed that the short-term use of PPIs does not result in higher rates of hypomagnesemia and associated arrhythmia in comparison to H2RA consumption after off-pump CABG.

Highlights

Hasan Abbaspour(google scholar)(pubmed)

Arash Peivandi Yazdi(google scholar)(pubmed)

Seyed Javad Purafzali Firuzabadi(google scholar)(pubmed)

Vida vakili(google scholar)(pubmed)

Mohamad Abbasi Tashnizi(google scholar)(pubmed)

Shahram Amini(google scholar)(pubmed)

Keywords

Proton-pump inhibitors (PPI)
Hypomagnesemia
Arrhythmia
Off-pump CABG
Histamine 2-receptor antagonist (H2RA)
Subjects
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Journal of Kerman University of Medical Sciences
Volume 30, Issue 6 - Serial Number 6
November and December 2023
Pages 344-348

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