RESUMO
OBJECTIVES: Proton pump inhibitor use is associated with increased gastric wall activity on myocardial perfusion imaging; however, the clinical impact is unknown. We sought to determine the association of the use of proton pump inhibitors and nine other commonly prescribed classes of medications on the risk of rescanning patients undergoing myocardial perfusion imaging. METHODS: A matched case-control study was performed including 337 rescanned cases and 337 same-day controls from a total of 5432 patients undergoing myocardial perfusion imaging (MPI) over a 4-year period. RESULTS: The odds of rescanning was higher in patients taking a proton pump inhibitor than those not [adjusted odds ratio (OR), 1.6; 95% confidence interval (CI), 1.1-2.2] and in those taking an angiotensin-converting enzyme inhibitor than those not (adjusted OR, 1.5; 95% CI, 1.0-2.2) adjusted for age, sex and BMI category. Eight other commonly prescribed medications showed no associations with rescanning. Among the cases of rescanning, the culprit organ site of extracardiac activity was the left lobe of the liver, 48%; gastric wall, 31%; gastric lumen, 12%; spleen, 7% and bowel <1%. Proton pump inhibitor use was strongly associated with rescanning due to gastric wall uptake (adjusted OR, 6.3; 95% CI, 2.8-14.1) but not the other causes of rescanning. CONCLUSIONS: Proton pump inhibitor use and angiotensin-converting enzyme inhibitor use are associated with an increased risk of rescanning of patients undergoing MPI. Gastric wall activity is likely to account for the excess cases of rescanning in those taking a proton pump inhibitor.
