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        The Changing Epidemiology of Gastroesophageal Reflux Disease: Are Patients Getting Younger?

        ( Takahisa Yamasaki ),( Colin Hemond ),( Mohamed Eisa ),( Stephen Ganocy ),( Ronnie Fass ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2018 Journal of Neurogastroenterology and Motility (JNM Vol.24 No.4

        Background/Aims Gastroesophageal reflux disease (GERD) is a common disease globally with increasing prevalence and consequently greater burden on the Healthcare system. Traditionally, GERD has been considered a disease of middle-aged and older people. Since risk factors for GERD affect a growing number of the adult population, concerns have been raised that increasingly younger people may develop GERD. We aim to determine if the proportion of younger patients has increased among the GERD population. Methods The incidence of GERD as well as several variables were evaluated during an 11-year period. Explorys was used to evaluate datasets at a “Universal” and Healthcare system in northern Ohio to determine if trends at a local level reflected those at a universal level. GERD patients were classified into 7 age groups (15-19, 20-29, 30-39, 40-49, 50-59, 60-69, and ≥ 70 years). Results The proportion of patients with GERD increased in all age groups, except for those who were ≥ 70 years in the universal dataset (P< 0.001) and those who were ≥ 60 years in the Healthcare system (P < 0.001). The greatest rise was seen in 30-39 years in both datasets (P < 0.001). Similarly, the proportion of GERD patients who were using proton pump inhibitors increased in all age groups except for those who were ≥ 70 years in both datasets (P < 0.001), with the greatest increase being the group 30-39 years (P <0.001). Conclusion Over the last decade, there has been a significant increase in the proportion of younger patients with GERD, especially those within the age range of 30-39 years. (J Neurogastroenterol Motil 2018;24:559-569)

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        The Risk of Acute Myocardial Infarction in Patients With Gastroesophageal Reflux Disease

        ( Mohamed Eisa ),( Annumeet Sandhu ),( Ravi Prakash ),( Stephen J Ganocy ),( Ronnie Fass ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2020 Journal of Neurogastroenterology and Motility (JNM Vol.26 No.4

        Background/Aims A number of inflammatory mediators have been documented to be elevated in gastroesophageal reflux disease (GERD). Similar inflammatory mediators are involved in coronary artery disease. Thus, the aim of the study is to determine if GERD is a risk factor for developing acute myocardial infarction (AMI). Methods We used Explorys, a private cloud-based data store to which a number of health care systems feed information. We identified a cohort of GERD patients who have undergone an esophagogastroduodenoscopy compared to those without GERD. Incidence of AMI was studied after statistically controlling for known AMI risk factors. Results Total of 200 400 patients were included in the GERD group and 386 800 patients in non-GERD group. The primary event of AMI occurred in 17 200 patients in the GERD group (8.6%) vs 24 300 in non-GERD group (6.3%). Using logistic regression analysis and controlling for 6 major risk factors which included male gender (OR, 1.09; 95% CI, 1.07-1.11; P < 0.001), hypertension (OR, 6.53; 95% CI, 6.21-6.88; P < 0.001), hyperlipidemia (OR, 3.08; 95% CI, 2.96-3.20; P < 0.001), diabetes mellitus (OR, 1.72; 95% CI, 1.69- 1.76; P < 0.001), obesity (OR, 1.02; 95% CI, 1.00-1.04; P = 0.044), and smoking (OR, 1.38; 95% CI, 1.35-1.41; P < 0.001). The odds of developing AMI in the GERD population was 1.11 (95% CI, 1.08-1.13; P < 0.001). GERD had higher odds of developing AMI than male gender or obesity in our study. Conclusions This study demonstrated that GERD is a risk factor for AMI, higher than male gender and obesity. However, the increased risk may be clinically insignificant. (J Neurogastroenterol Motil 2020;26:471-476)

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