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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Correlates and consequences of gastrointestinal bleeding complicating percutaneous coronary intervention

Michael A Gaglia1, Rebecca Torguson, Manuel A Gonzalez

  • 1Washington Hospital Center, Washington, DC, USA.

The American Journal of Cardiology
|October 6, 2010
PubMed

Insights

Gastrointestinal bleeding (GIB) after percutaneous coronary intervention (PCI) significantly increases short-term mortality. However, bivalirudin use was linked to reduced GIB risk, and GIB did not impact long-term outcomes in survivors.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Clinical Research

Background:

  • Gastrointestinal bleeding (GIB) is a serious complication of percutaneous coronary intervention (PCI), associated with high mortality.
  • Understanding the clinical factors and long-term outcomes related to GIB after PCI is crucial for patient management.

Purpose of the Study:

  • To identify clinical and procedural factors associated with GIB complicating PCI.
  • To evaluate the impact of GIB on 30-day mortality and 1-year major adverse cardiac events (MACEs).

Main Methods:

  • Retrospective analysis of 20,621 patients undergoing PCI between January 2000 and January 2010.
  • Multivariable logistic regression and Cox proportional hazards regression were used to identify predictors of GIB and mortality.
  • Landmark analysis assessed the impact of GIB on 1-year MACEs in hospital survivors.

Main Results:

  • In-hospital GIB occurred in 0.72% of patients (147 cases).
  • Risk factors for GIB included older age, shock, acute myocardial infarction, renal insufficiency, lower hematocrit, and glycoprotein IIb/IIIa inhibitors; bivalirudin was protective.
  • GIB significantly increased unadjusted 30-day mortality (20.5% vs. 2.4%) and was a key correlate of mortality, along with shock.
  • GIB was not associated with adjusted 1-year mortality or MACEs in patients surviving to discharge.

Conclusions:

  • Gastrointestinal bleeding complicating PCI has a substantial impact on 30-day mortality.
  • Bivalirudin use is associated with reduced rates of GIB following PCI.
  • While GIB increases short-term mortality risk, it does not appear to affect long-term MACEs in survivors.

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