Gastroesophageal Reflux Disease (GERD) and Risk of Incident Acute Myocardial Infarction: A Systematic Review and Meta-Analysis of Cohort Studies.

Abstract

<h4>Aims</h4>Recent evidence suggests that gastroesophageal reflux disease (GERD) is associated with cardiovascular diseases, including increased coronary artery calcification. However, whether GERD is a risk factor for acute myocardial infarction (AMI) remains uncertain. This study aims to clarify this association through a systematic review and meta-analysis.<h4>Methods and results</h4>We searched MEDLINE and EMBASE databases from inception to January 2025, including cohort studies that compared AMI incidence in individuals with and without GERD. Relative risk (RR), hazard ratio (HR), and 95% confidence intervals (CIs) were extracted and combined using a random-effects model with the generic inverse variance method. Our meta-analysis included six cohort studies with 1 324 362 participants. Patients with GERD had a 27% increased risk of incident AMI compared to those without GERD (pooled RR: 1.27, 95% CI: 1.13-1.47; <i>I</i> ² = 88%, <i>p</i> = 0.0001). The funnel plot showed no significant publication bias. Potential mechanisms underlying this association include chronic inflammation, oxidative stress, and autonomic dysfunction.<h4>Conclusion</h4>These findings suggest that GERD may contribute to AMI risk, highlighting the need for further research into preventive strategies and targeted interventions, such as acid suppression therapy and lifestyle modifications, to mitigate cardiovascular risk in GERD patients. Future studies should also explore mechanistic pathways to better understand this link and improve patient care.