Are proton pump inhibitors among the risk factors for acute coronary syndrome? A multi-centric case-control study between patients attending governmental hospitals in western Saudi Arabia

Saudi Med J. 2019 Nov;40(11):1098-1104. doi: 10.15537/smj.2019.11.24602.


Objectives: To identify the predictors of acute coronary syndrome (ACS) and to determine the relationship between usage of proton pump inhibitors (PPIs) and the occurrence of a first non-fatal ACS event among patients that attended governmental hospitals in Jeddah, Saudi Arabia.

Methods: A matched, multi-centric case-control study was performed between January and June of 2015 in Jeddah involving 2 governmental hospitals and the main university hospital. A total of 118 cases aged ≥18 years who were recently diagnosed with ACS were selected. For each case, one control matched by age and gender was selected. Information from an interview questionnaire and from reviewing patients' medical records was recorded on a standardized data collection sheet.

Results: Risk factors for ACS and the relationship between usage of PPIs and the occurrence of a first non-fatal ACS event were measured in 236 cases and matched controls. Current smoking (OR: 4.5; 95% CI: 1.92-10.98), excessive body weight (OR: 2.99; 95% CI: 1.38-6.45), and dyslipidemia (OR: 2.51; 95% CI: 1.07-5.84) were the predictors of ACS. Hypertension, diabetes, and moderate-to-high physical activity were associated with ACS. However, there was no statistical association between use of PPIs and occurrence of the first non-fatal ACS event (p greater than 0.05).

Conclusions: There was no association between PPIs and the occurrence of a first non-fatal ACS event. Smoking, increased weight, and dyslipidemia are considered predictors of ACS. Furthermore, ACS is associated with self-reported diabetes, hypertension, and physical activity.

Publication types

  • Multicenter Study

MeSH terms

  • Acute Coronary Syndrome / chemically induced*
  • Acute Coronary Syndrome / epidemiology
  • Case-Control Studies
  • Hospitals, Public / organization & administration*
  • Humans
  • Proton Pump Inhibitors / adverse effects*
  • Risk Factors
  • Saudi Arabia / epidemiology


  • Proton Pump Inhibitors