Health-related quality of life in patients with cardiovascular disease--the effect of upper gastrointestinal symptom treatment.
BACKGROUND
Upper gastrointestinal discomfort decreases the already impaired health status of patients with cardiovascular disease.


OBJECTIVE
To evaluate whether acid suppressive therapy improves health-related quality of life in patients who developed upper gastrointestinal symptoms after starting low-dose acetylsalicylic acid.


METHODS
In a double-blind, placebo-controlled randomized trail, cardiac patients using low-dose (80 mg) acetylsalicylic acid with (n = 142) and without (n = 90) upper gastrointestinal symptoms were included. Patients with symptoms were treated with rabeprazole or placebo for 4 weeks. At baseline and 4 weeks information about gastrointestinal symptoms and health-related quality of life was assessed.


RESULTS
The 73 patients assigned to rabeprazole when compared with 69 patients given placebo reported the same quality of life scores 4 weeks after randomization. The differences in quality of life scores between patients with and without symptoms at baseline remained after 4 weeks. Patients in whom treatment led to complete symptom relief or those who remained symptom-free reported significantly higher scores for Physical Component Summary (P < 0.01) and Mental Component Summary (P < 0.01), when compared to those with persistent symptoms or new onset symptoms.


CONCLUSIONS
Proton-pump inhibitor therapy did not improve quality of life. Upper gastrointestinal symptom relief in itself considerably increased quality of life.
van Rossum
L G M
LG
Department of Gastroenterology, Heart Center, University Medical Center St Radboud, PO Box 9101, 6500 HB Nijmegen, The Netherlands. l.vanrossum@mdl.umcn.nl
Laheij
R J F
RJ
Vlemmix
F
F
Jansen
J B M J
JB
Verheugt
F W A
FW
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000150:complications*; D004311:Double-Blind Method; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000031:analogs & derivatives; D011788:Quality of Life; D064750:Rabeprazole
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D064750:Rabeprazole; D009853:Omeprazole