warfarin and Gastroesophageal-Reflux

Patients on warfarin plus antiplatelet/NSAID regimens are likely to benefit from the gastroprotective effect of PPIs. For patients taking warfarin alone, it's a different story.

Topics: Anticoagulants; Atrial Fibrillation; Drug Administration Schedule; Drug Therapy, Combination; Gastroesophageal Reflux; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Proton Pump Inhibitors; Risk Factors; Warfarin

Although gastroesophageal reflux disease (GERD) causes noncardiac chest pain mimicking angina pectoris, systemic studies surveying the effects of common cardiac drugs on symptomatic GERD are rare.. To investigate the drugrelated GERD, this multicenter trial enrolled 201 consecutive cardiac outpatients (69.7 ± 10.5 y) after obtaining written informed consent. They were assessed using the Frequency Scale for Symptoms of GERD (F-scale) to screen for GERD with a cut-off value of 8.0. Clinical background was obtained from medical records. Gastric medicine was empirically administered at the discretion of the attending physician. F-scale score and incidence of GERD were analyzed individually in relation to background and prescription.. The average F-scale score did not correlate with gender, age or underlying diseases. F-scale score was elevated significantly (p = 0.006) by administration of calcium channel blockers to the patients treated with gastric medicine, suggesting that calcium channel blockers exacerbate the possibly preexisting GERD. Incidence of GERD within 2 months after starting warfarin tended to be greater than that at other durations (p = 0.087). Patients showing a high score (≥ 8.0) suggestive of GERD showed a correlation with the combined administration of calcium channel blockers (OR = 3.19; 95% CI of 1.01 - 10.11; p = 0.049) and warfarin (OR = 3.05; 95% CI of 1.00 - 9.27; p = 0.049) in the best logistic model.. Although larger cohort is required, this survey demonstrates that the combination of calcium channel blockers and warfarin is an independent risk factor for GERD.

Topics: Adult; Aged; Aged, 80 and over; Anticoagulants; Calcium Channel Blockers; Female; Gastroesophageal Reflux; Humans; Male; Middle Aged; Surveys and Questionnaires; Warfarin

Topics: Aged; Anti-Arrhythmia Agents; Anticoagulants; Atrial Fibrillation; Digoxin; Drug Interactions; Drug Therapy, Combination; Enzyme Inhibitors; Female; Gastroesophageal Reflux; Humans; Omeprazole; Proton Pump Inhibitors; Risk Factors; Warfarin