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Factors associated with myocardial infarction after emergency endoscopy for upper gastrointestinal bleeding in

Ching-Tai Lee1, Shih-Pei Huang, Tsu-Yao Cheng

  • 1Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.

The American Journal of Emergency Medicine
|December 13, 2006
PubMed

Insights

Emergency endoscopy for upper GI bleeding poses risks for high-risk patients. Factors like heart disease, low blood pressure, and shock increase the likelihood of procedure-related myocardial infarction (MI).

Area of Science:

  • Cardiology
  • Gastroenterology
  • Emergency Medicine

Background:

  • Myocardial infarction (MI) following emergency endoscopy for upper gastrointestinal bleeding is associated with high mortality.
  • Identifying factors contributing to procedure-related MI in high-risk individuals is crucial.

Purpose of the Study:

  • To investigate factors associated with myocardial infarction (MI) occurring after emergency endoscopy in high-risk patients.
  • To identify predictors of procedure-related MI in patients undergoing emergency endoscopy for upper gastrointestinal bleeding.

Main Methods:

  • A cohort of 108 high-risk patients (coronary artery disease or age-based risk) undergoing emergency endoscopy was enrolled.
  • Patients were categorized into three groups: MI before endoscopy (pre-PES MI), MI after endoscopy (post-PES MI), or no MI.
  • Demographic, laboratory, and outcome data were collected and analyzed.

Main Results:

  • Five patients (4.6%) experienced MI before endoscopy, and five (4.6%) had MI after endoscopy.
  • Post-PES MI patients were significantly more likely to have pre-existing heart disease (60.0% vs 12.2%).
  • Lower systolic pressure (86.2 vs 128.0 mm Hg), lower diastolic pressure (50.0 vs 69.5 mm Hg), lower hemoglobin (6.7 vs 9.1 g/dL), and persistent shock (80.0% vs 13.3%) were significantly associated with post-PES MI.

Conclusions:

  • Pre-existing heart disease is a significant risk factor for post-endoscopy MI.
  • Hemodynamic instability, indicated by lower blood pressure and persistent shock, along with lower hemoglobin levels on arrival, are associated with increased risk of procedure-related MI.
  • These findings highlight critical factors for risk stratification and management in high-risk patients undergoing emergency endoscopy.
Abstract

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