Abstract
<title>Abstract</title> <p> Ischemic heart disease (IHD) is associated with systemic vascular dysfunction, chronic inflammation, and tissue hypoxia, which may contribute to upper gastrointestinal mucosal injury. However, the relationship between IHD duration and specific endoscopic gastric abnormalities remains insufficiently explored. <bold>Aim:</bold> To evaluate the association between IHD duration and upper gastrointestinal endoscopic findings after adjustment for age and sex. <bold>Methods:</bold> This retrospective cross-sectional study included 2,924 patients with IHD who underwent upper gastrointestinal endoscopy. Patients were stratified according to disease duration (≤1 year and >1 year). Endoscopic findings included gastric atrophy, hyperemia, hyperplasia, and esophagitis. Multivariable logistic regression was used to estimate adjusted odds ratios (OR) with 95% confidence intervals (CI). <bold>Results:</bold> Gastric hyperemia was significantly associated with IHD duration (OR = 1.79, 95% CI: 1.05–3.05, p = 0.033). No significant associations were observed for gastric atrophy, hyperplasia, or esophagitis. Age was a strong independent predictor of gastric atrophy, hyperplasia, and esophagitis (p < 0.001). Female sex was inversely associated with gastric hyperemia (OR = 0.48, 95% CI: 0.31–0.73, p = 0.001). <bold>Conclusion:</bold> IHD duration is independently associated only with gastric hyperemia, whereas age is the dominant determinant of most gastric mucosal changes. These findings highlight the importance of age-related gastrointestinal vulnerability in patients with IHD. </p>