title: Ischemic heart disease, factor predisposing to Barrett's adenocarcinoma: A case control study.
abstract: OBJECTIVE
  To define the significance of ischemic heart disease (IHD) (stable angina to infarction) co-existance in Barrett esophagus (BE) patients and patients with esophageal adenocarcinoma (AdE).
  
  
  METHODS
  All BE/AdE patients in Blackpool-Wyre-Fylde area and Trikala prefecture identified from medical records. Patient clinical details were obtained from hospital and General Practitioner records. Additional information was gathered from validated questionnaire.
  
  
  RESULTS
  Forty (33%) AdE and 83 (19%) BE patients had IHD (P = 0.002). Eighteen (15%) AdE and 34 (8%) BE patients had suffered a myocardial infarction (P = 0.03). Three (3%) AdE and 7 (2%) BE patients had severe heart failure (P = 0.82). Thirty-nine (47%) BE with IHD and 8 (20%) AdE patients with IHD consumed aspirin daily (P = 0.004). Seventh-seven (93%) BE patients with IHD and 36 (90%) AdE patients with IHD were on statins (P = 0.86). Logistic regression analysis: AdE was more frequent in the elderly, with long term reflux, long BE and concurrent IHD (odds ratio: 2.086, P = 0.001) not consuming statins. Eighteen (22%) BE patients with IHD [16 (84%) with myocardial infarction] vs 33 (10%) without IHD died from non-neoplastic causes within 24 mo from BE diagnosis (P = 0.005).
  
  
  CONCLUSIONS
  IHD is more prevalent in AdE than BE patients. Increased prevalence of AdE is related with the presence of myocardial infarction but not severe heart failure, possibly because patients with BE and severe IHD have low life expectancy.
authors.affiliation: Panagiotis Tsibouris, Panagiota Mavrogianni, Gastroenterology Department, NIMTS General Hospital, 11521 Athens, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Tsibouris
authors.affiliation: Panagiotis Tsibouris, Panagiota Mavrogianni, Gastroenterology Department, NIMTS General Hospital, 11521 Athens, Greece.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Hendrickse
authors.affiliation: Panagiotis Tsibouris, Panagiota Mavrogianni, Gastroenterology Department, NIMTS General Hospital, 11521 Athens, Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Mavrogianni
authors.affiliation: Panagiotis Tsibouris, Panagiota Mavrogianni, Gastroenterology Department, NIMTS General Hospital, 11521 Athens, Greece.
authors.forename: Peter Et
authors.initials: PE
authors.lastname: Isaacs
keywords: Barrett esophagus; Esophageal adenocarcinoma; Ischemic heart disease; Myocardial infarction; Non-steroidal anti-inflammatory drugs