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Acid reflux in patients with coronary artery disease and refractory chest pain

Yijun Liu1, Suyu He, Yongjun Chen

  • 1Department of Cardiology, Suining Central Hospital, China.

Internal Medicine (Tokyo, Japan)
|June 4, 2013
PubMed

Insights

Acid reflux is common in patients with coronary artery disease (CAD) and refractory chest pain, potentially causing noncardiac chest pain. Proton pump inhibitor (PPI) therapy improved esophageal pH and quality of life.

Area of Science:

  • Cardiology
  • Gastroenterology

Background:

  • Refractory chest pain in coronary artery disease (CAD) patients is often challenging to manage.
  • Gastroesophageal reflux disease (GERD) can mimic or exacerbate cardiac symptoms.

Purpose of the Study:

  • To investigate the link between acid reflux and chest pain/ischemic events in CAD patients.
  • To assess the impact of cardiac drugs on acid reflux.
  • To evaluate the effect of proton pump inhibitor (PPI) therapy on GERD symptoms and quality of life in these patients.

Main Methods:

  • Simultaneous 24-hour esophageal pH monitoring and electrocardiogram (ECG) Holter monitoring were performed on 64 patients.
  • Ischemic events and cardiac drug use were compared between patients with and without GERD.
  • GERD patients received 14-day omeprazole therapy, with outcomes assessed via pH monitoring, Holter, and SF-36 questionnaire.

Main Results:

  • GERD was prevalent (69%) in patients with CAD and refractory chest pain.
  • GERD patients experienced a higher incidence and longer duration of ischemic events.
  • Proton pump inhibitor (PPI) therapy reduced ischemic events and improved SF-36 scores.

Conclusions:

  • Acid reflux is a significant contributor to refractory chest pain in CAD patients, potentially representing noncardiac chest pain (NCCP).
  • Certain cardiac drugs may increase the risk or severity of GERD.
  • Short-term PPI therapy effectively normalizes esophageal pH and enhances health-related quality of life (HRQL).
Abstract

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