Unexplained chest/epigastric pain in patients with normal endoscopy as a predictor for ischemic heart disease and mortality: A Danish 10-year cohort study
Normal upper endoscopy may be a marker of ischemic heart disease in patients with unexplained chest/epigastric pain.
Methods: We examined the 10-year risk of ischemic heart disease and mortality in a cohort of 386 Danish patients with chest/epigastric pain, normal upper endoscopy, and no prior hospital discharge diagnosis of ischemic heart disease (defined as patients with unexplained chest/epigastric pain), compared with 3,793 population controls matched by age, gender, and residence. Outcome data were obtained from population-based health registries.
Cox regression analysis was used to estimate the relative risk of hospitalization for ischemic heart disease and the adjusted mortality rate ratio (MRR).
Results: The 10-year relative risk of hospitalization for ischemic heart disease following a normal upper endoscopy among patients with unexplained chest/epigastric pain was 1.6 (95% CI, 1.1-2.2), compared with controls.
The 10-year MRR was 1.1 (95% CI, 0.9-1.5). Within the first year after the upper endoscopy the MRR was 2.4 (95% CI, 1.3-4.5).
The cause-specific MRR among patients with unexplained chest/epigastric pain compared with controls was up to threefold higher for deaths related to alcohol dependence, pneumonia, and lung cancer.
Conclusions: Unexplained chest/epigastric pain in patients with normal endoscopy is a strong marker for ischemic heart disease and increased mortality.
Author: Estrid Muff Munk, Bente Noergaard, Claus Dethlefsen, Hans Gregersen, Asbjoern Mohr Drewes, Peter Funch-Jensen and Henrik Toft Soerensen
Credits/Source: BMC Gastroenterology 2008, 8:28
Published on: 2008-07-15
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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