RESUMEN
BACKGROUND: No studies have examined the risk of upper gastrointestinal diseases among patients with unexplained chest/epigastric pain (UCEP) and a normal upper endoscopy. AIM: To examine the relative risk of peptic ulcer, oesophagitis, pancreatitis or gallstone in UCEP patients. METHODS: This Danish 10-year cohort study focused on UCEP patients (n = 386), diagnosed in 1992-93. Ten age- and gender-matched controls were selected per patient from Denmark's Civil Registration System (n = 3860). Kaplan-Meier analysis and Cox's regression analysis was used to calculate the risk of hospitalization for peptic ulcer, oesophagitis, pancreatitis or gallstone. RESULTS: Compared with controls, the adjusted relative risks among UCEP patients <1 and > or = 1 year after upper endoscopy were for peptic ulcer 2.0 [95% confidence interval (CI) 0.2-18.4] and 1.7 (95% CI 0.9-3.4), for oesophagitis 8.2 (95% CI 1.2-59.2) and 1.9 (95% CI 0.7-5.0), for pancreatitis 9.2 (95% CI 2.0-41.8) and 3.9 (95% CI 1.4-10.5), and for gallstone 14.1 (95% CI 5.4-37.2) and 3.3 (95% CI 1.9-5.8). CONCLUSIONS: UCEP is positively associated with all study outcomes especially in the first year after upper endoscopy, indicating that peptic ulcer, oesophagitis, pancreatitis or gallstone could be underlying early UCEP symptoms. However, the long-term association remained strong for pancreatitis and gallstone, suggesting a genuine excess risk.
Asunto(s)
Dolor en el Pecho/etiología , Esofagitis/diagnóstico , Cálculos Biliares/diagnóstico , Pancreatitis/diagnóstico , Úlcera Péptica/diagnóstico , Adulto , Estudios de Cohortes , Endoscopía del Sistema Digestivo/métodos , Esofagitis/complicaciones , Femenino , Cálculos Biliares/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Pancreatitis/complicaciones , Úlcera Péptica/complicaciones , Factores de RiesgoRESUMEN
BACKGROUND: Case reports have suggested that statins may cause acute pancreatitis. AIM: To examine if statins are associated with risk of acute pancreatitis. METHODS: We identified 2576 first-time admitted cases of acute pancreatitis from hospital discharge registers in three Danish counties, and 25 817 age- and gender-matched controls from the general population. Prescriptions for statins prior to admission with acute pancreatitis or index date among controls were retrieved from prescription databases. We used conditional logistic regression analysis to estimate odds ratios for acute pancreatitis among ever (ever before), current (0-90 days before), new (first prescription in 0-90 days before) and former (>90 days, but not 0-90 days before) users of statins. RESULTS: Adjusted odds ratios for acute pancreatitis among ever, current, new and former users of statins were 1.44 (95% confidence interval: 1.115-1.80), 1.26 (95% confidence interval: 0.96-1.64), 1.01 (95% confidence interval: 0.43-2.37) and 2.02 (95% confidence interval: 1.37-2.97), respectively. There was an indication of an inverse association between the number of filled prescriptions and risk of acute pancreatitis. CONCLUSIONS: Our findings speak against a strong causative effect of statins on the risk of acute pancreatitis, and may even indicate a mild protective effect.