Prevalence of linked angina and gastroesophageal reflux disease in general practice

Abstract

AIM:To evaluate the association between gastroesophageal reflux diseases (GERD) and coronary heart diseases. METHODS:One thousand nine hundred and seventy consecutive patients who attended our hospital were enrolled. All of the patients who first attend our hospital were asked to respond to the F-scale questionnaire regardless of their chief complaints. All patients had a careful history taken, and resting echocardiography (ECG) was performed by physicians if the diagnostic necessity arose. Patients with ECG signs of coronary artery ischemia were defined as STsegment depression based on the Minnesota code. RESULTS:Among 712 patients (36%) with GERD, ECG was performed in 171 (24%), and ischemic changes were detected in eight (5%). Four (50%) of these patients with abnormal findings upon ECG had no chest symptoms such as chest pain, chest oppression, or palpitations. These patients (0.6%; 4/712) were thought to have non-GERD heartburn, which may be related to ischemic heart disease. Of 281 patients who underwent ECG and did not have GERD symptoms, 20 (7%) had abnormal findings upon ECG. In patients with GERD symptoms and ECG signs of coronary artery ischemia, the prevalence of linked angina was considered to be 0.4% (8/1970 patients). CONCLUSION:The present study suggested that ischemic heart disease might be found although a patient was referred to the hospital with a complaint of GERD symptoms. Physicians have to be concerned about missing clinically important coronary artery disease while evaluating patients for GERD symptoms.

Effect of Multiple Doses of Omeprazole on the Pharmacokinetics, Pharmacodynamics, and Safety of a Single Dose of Rivaroxaban

“…41 It is possible that when a clopidogrel-receiving patient presents with nonspecific upper gastrointestinal chest pain, the potential exists for the patient to be prescribed a PPI, even though the pain was a consequence of myocardial ischemia. 42 Patients may receive both PPIs and antianginal drugs; retrospective analyses of health care system databases suggest that 1-year MACE rates were significantly higher among patients who were prescribed PPI therapy within 30 days of an MACE, and the use of rescue nitroglycerin among patients receiving both clopidogrel and a PPI was double the rate of patients receiving clopidogrel alone. 41 Physicians commonly prescribe PPIs with antianginal drugs, as epigastric discomfort or gastroesophageal reflux disease presents as chest pain.…”

Reflux Esophagitis and the Risk of Stroke in Young Adults

“…9,10 There also have been a few epidemiological studies exploring the link between GERD and cardiovascular diseases. 11,12 Using the UK General Practice Research Database, Ruigómez et al 11 demonstrated that patients with GERD had an increased risk of subsequent diagnosis of angina.…”

Effect of omeprazole on patient-reported outcome measures in uninvestigated heartburn: a multi-country, multi-center observational study

“…Heartburn occurs predominantly in the upper gastrointestinal tract (GIT) and is a key presentation in gastroesophageal reflux disease (GERD) and gastritis. 1,2 GERD and gastritis, the most common debilitating conditions of the GIT, are characterized by an orderly occurrence of injury or inflammation in the innermost layer of the oesophagus and stomach. 3,4 Several risk factors increase the frequency and severity of the condition including, smoking, high body mass index, limited physical activity, and certain medications (such as anti-inflammatory and cytotoxic drugs).…”