{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T04:23:25Z","timestamp":1764563005993,"version":"3.46.0"},"reference-count":53,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003452","name":"Innovation and Technology Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003452","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The conflicting findings on the association between proton pump inhibitors (PPIs) and ischaemic stroke could be due to residual confounding. Self\u2010controlled case series (SCCS) can be used to avoid time\u2010invariant confounding. Additionally, different baseline risks of stroke should be considered, as some individuals may be prescribed PPIs for gastroprotection from bleeding with antithrombotic drugs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified adult patients with incident ischaemic stroke from 2003 to 2014 in Hong Kong and applied the modified SCCS. The exposure window was pre\u2010defined as Days 1\u201330, 31\u201360, 61\u201390, and 91 to the prescription end, since the PPI prescription. All other periods were referent windows. We estimated incidence rate ratios (IRR) and stratified them further using antithrombotic drugs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 18\u2009170 patients were included. The IRRs for ischaemic stroke were 1.55 (95% CI: 1.00\u20132.42) during days 61 to 90, 1.51 (95% CI: 1.14\u20132.00) during days 91 to end, versus the referent window. There was no evidence of an increased risk in other risk windows versus the referent windows. In the stratified analysis, we observed an increased risk in people co\u2010prescribed PPIs with antithrombotic drugs in all risk periods, but no increased risks among those with PPI monotherapy versus the referent window.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>No evidence of a higher ischaemic stroke after monotherapy of PPI use. The increased risk of ischaemic stroke associated with PPIs could be due to their high baseline risk prescribed with antithrombotic drugs for primary prevention. Clinical monitoring of ischaemic stroke is recommended in these people.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70219","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T14:04:16Z","timestamp":1758204256000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of Ischaemic Stroke Varies With Antithrombotic Drugs Use in Proton Pump Inhibitor Users: A Self\u2010Controlled Case Series Study"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9074-633X","authenticated-orcid":false,"given":"Min","family":"Fan","sequence":"first","affiliation":[{"name":"Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong Special Administration Region China"},{"name":"Hong Kong Science Park, Hong Kong Science and Technology Park  Hong Kong Special Administration Region China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7895-198X","authenticated-orcid":false,"given":"Joseph E.","family":"Blais","sequence":"additional","affiliation":[{"name":"Hong Kong Science Park, Hong Kong Science and Technology Park  Hong Kong Special Administration Region China"},{"name":"School of Public Health, LKS Faculty of Medicine The University of Hong Kong  Hong Kong Special Administration Region China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8242-0014","authenticated-orcid":false,"given":"Ian C. K.","family":"Wong","sequence":"additional","affiliation":[{"name":"Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong Special Administration Region China"},{"name":"Hong Kong Science Park, Hong Kong Science and Technology Park  Hong Kong Special Administration Region China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse","family":"Zhao","sequence":"additional","affiliation":[{"name":"Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong Special Administration Region China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ka Shing","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Clinical Medicine The University of Hong Kong, Queen Mary Hospital  Hong Kong Special Administration Region China"},{"name":"Department of Medicine The University of Hong Kong\u2010Shenzhen Hospital  Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7602-9470","authenticated-orcid":false,"given":"Esther W. 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