Is there any association between myocardial infarction, gastro-oesophageal reflux disease and acid-suppressing drugs?
Aliment Pharmacol Ther 2003;18:973-978.
ABSTRACT
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 10000 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: 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 gastrooesophageal 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 gastrooesophageal 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.
Conclusions: 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.
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.