The Association Between Proton Pump Inhibitors and Incident Asthma in Patients with Coronary Artery Disease: A Population-Based Cohort Study

Abstract Observational studies have found a significant association between acid-suppressive drug use and incident asthma. However, the association between proton pump inhibitors (PPIs) and incident asthma in patients with coronary artery disease (CAD) is unclear. Thus, this study assessed the association between PPI use and incident asthma in patients with CAD. We conducted a retrospective cohort study using the National Health Insurance Research Database in Taiwan from 2004 to 2013. Each patient who took PPIs was assigned to the PPI group, whereas 1:1 sex-, age-, and drug index date-matched randomly selected patients without PPI prescription were assigned to the non-PPI group. We analyzed the risk of incident asthma using Cox proportional hazard regression models, including sex, age, urbanization, low income, and comorbidities. Sensitivity and subgroup analyses were also conducted. A total of 8499 cases were identified as PPI‐treated patients, and 8,499 subjects were included in the control group of PPI non‐users. After adjusting for sex, age, urbanization, low income, and comorbidities, PPI user was associated with a 1.18-fold (HR: 1.18; 95% CI: 1.05–1.34) increase for incident asthma in patients with CAD. We concluded that PPI use increased the risk of incident asthma in patients with CAD. The risk of incident asthma should be considered when weighing the benefits and risks of PPI and aspirin treatment in patients with CAD in clinical practice.