The effect of double dose of omeprazole on the course of angina pectoris and treadmill stress test in patients with coronary artery disease--a randomised, double-blind, placebo controlled, crossover trial.
BACKGROUND
Gastroesophageal reflux (GER) and coronary artery disease (CAD) frequently overlap, making the proper diagnosis of chest pain more difficult. GER symptoms may mistake anginal chest pain, and oesophageal acidification may induce myocardial ischaemia both in the rest and in the effort. Increase of oesophageal pH should prevent these conditions.


OBJECTIVE
To estimate the effect of double omeprazole dose on the course of angina pectoris and treadmill stress test in patients with coronary artery disease (CAD), using double-blind, crossover randomised, placebo-controlled study design.


METHODS
We studied 48 patients with angina pectoris symptoms and significant narrowing of coronary vessels in angiography. After baseline examination and treadmill stress test all subjects were randomised to treat either with omeprazole (20 mg b.i.d.) or placebo for 14 days, using a double-blind, crossover placebo controlled design.


RESULTS
Seventeen (35%) subjects reported more than by half decrease in symptoms severity after omeprazole and 6 (12%) after placebo (p=0,01). Omeprazole significantly decreased the number of chest pain episodes and number of nitroglycerin doses taken in the second week of both study phases, as well as the percentage of subjects with significant decrease of ST interval during the stress test (64% vs. 73%, p<0,05). However majority of other stress test parameters (i.e. test duration, DUKE index) have improved both after omeprazole and placebo administration (by 9-38%).


CONCLUSIONS
Double dose of omeprazole significantly decreased symptoms severity in 35% of patients with CAD, as well as frequency of some electrocardiographic signs of myocardial ischaemia during stress test.
Budzyński
Jacek
J
Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Department of Gastroenterology, Vascular Diseases and Internal Medicine, Ujejskiego 75 Street, PL85-168 Bydgoszcz, Poland. budz@cps.pl
Kłopocka
Maria
M
Pulkowski
Grzegorz
G
Suppan
Karol
K
Fabisiak
Jacek
J
Majer
Marcin
M
Swiatkowski
Maciej
M
D000704:Analysis of Variance; D000787:Angina Pectoris / Q000188:drug therapy* / Q000503:physiopathology; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D002637:Chest Pain / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D003327:Coronary Disease / Q000188:drug therapy / Q000503:physiopathology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D009853:Omeprazole