Is there any association between myocardial infarction, gastro‐oesophageal reflux disease and acid‐suppressing drugs?

Abstract

Summary Background : A link between gastro‐oesophageal reflux disease and coronary heart disease has been suggested. Aim : To estimate the incidence of myocardial infarction in patients with newly diagnosed gastro‐oesophageal reflux disease in comparison with that in the general population. Methods : A population‐based cohort study was performed in the UK. Patients aged 18–79 years with a first diagnosis of gastro‐oesophageal reflux disease (n = 7084) were identified and a group of 10 000 patients free of gastro‐oesophageal reflux disease were sampled. A nested case–control analysis was performed to assess the risk factors for myocardial infarction. Results : The incidence of myocardial infarction in the general population was 4.0 per 1000 person‐years [95% confidence interval (CI), 3.2–4.9] and 5.1 per 1000 person‐years (95% CI, 4.1–6.4) in patients with gastro‐oesophageal reflux disease. The relative risk of myocardial infarction in patients with gastro‐oesophageal reflux disease was 1.4 (95% CI, 1.0–1.9). The increased risk of myocardial infarction was limited to the immediate days after the diagnosis of gastro‐oesophageal reflux disease. Previous chest pain was an important predictor of myocardial infarction in patients free of gastro‐oesophageal reflux disease. No association was found between the use of acid‐suppressing drugs and the risk of myocardial infarction. Conclusion : Our results suggest that gastro‐oesophageal reflux disease is not an independent predictor of myocardial infarction. Rather, the increased risk of myocardial infarction in patients with gastro‐oesophageal reflux disease in the immediate days after diagnosis indicates that prodromal ischaemic symptoms were misinterpreted as reflux symptoms.

Large Waist Circumference Is a Risk Factor for Reflux Esophagitis in Japanese Males

“…In a population-based cohort study, subjects with reflux esophagitis seemed to have a higher mortality rate after the exclusion of deaths associated with a diagnosis of esophageal cancer compared with the general population [39]. Furthermore, an increased risk of myocardial infarction in patients with GERD was reported [40]. Thus, males with reflux esophagitis may have a higher risk for cardiovascular disease and all-cause death.…”

Does gastro-esophageal reflux provoke the myocardial ischemia in patients with CAD?

“…Therefore, it should be anticipated that, in case of coexistence of GERD and CAD, treatment of gastro-esophageal reflux should be more aggressive. Another important clinical problem has been raised by a large population-based cohort study by Johansson et al [33]. They have analyzed association between the diagnosis of GERD, treatment with acid suppressing drugs and the risk of myocardial infarction (MI).…”

The heart and the oesophagus: intimate relations

“…The increased risk was limited to the immediate days after the diagnosis was made, and probably reflects a misinterpretation of the presenting symptoms rather than the triggering of myocardial infarction by reflux. 23 …”