One-Year Survival is Not Affected by Gastrointestinal Bleeding After Percutaneous Coronary Interventions
Kyari Sumayin Ngamdu1, Wael El Mallah2, Alok Dwivedi3
1Division of General Internal Medicine, Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, El Paso, Texas.
Insights
Gastrointestinal bleeding after percutaneous coronary intervention (PCI) occurred in 10.2% of patients. This bleeding did not increase mortality, but females and Hispanics had higher rates, warranting further study.
Area of Science:
- Cardiology
- Gastroenterology
- Internal Medicine
Background:
- Percutaneous coronary intervention (PCI) is a primary treatment for acute coronary syndromes, requiring antithrombotic therapy.
- Gastrointestinal (GI) bleeding post-PCI is a potential complication that may increase mortality.
- This study investigated the characteristics and outcomes of GI bleeding within one year after PCI.
Purpose of the Study:
- To compare the incidence and outcomes of GI bleeding in patients who underwent PCI.
- To identify patient demographics associated with increased risk of GI bleeding post-PCI.
- To evaluate the relationship between GI bleeding and all-cause mortality after PCI.
Main Methods:
- A retrospective cohort study analyzed data from 384 PCI procedures.
- GI bleeding and new onset anemia were assessed at 30 days, 90 days, and 1 year post-PCI.
- Statistical analyses included t-tests, Fisher exact tests, and Kaplan-Meier survival analysis.
Main Results:
- A total of 10.2% of patients experienced GI bleeding within one year of PCI.
- Females (16.8%) and Hispanic individuals (11.7%) showed a significantly higher incidence of GI bleeding compared to males and non-Hispanics, respectively.
- All patients who experienced GI bleeding survived the 1-year follow-up period.
Conclusions:
- A notable incidence of GI bleeding occurs after PCI, particularly in Hispanic populations.
- GI bleeding post-PCI was not associated with increased all-cause mortality in this study.
- Larger prospective studies are needed to confirm these findings and guide clinical practice.
Background:
Percutaneous coronary intervention (PCI) has been the main therapy in acute coronary syndromes, and early antithrombotic agents as well as 1-year dual antiplatelet therapy are required for adjuvant therapy. However, the development of post-PCI gastrointestinal (GI) bleeding may increase all-cause mortality. We compared the characteristics and outcomes of patients with GI bleeding within 1 year after PCI to those who did not develop bleeding.
Methods:
A retrospective cohort study was conducted using data from 384 PCI procedures performed between January 2011 and December 2013 at our hospital. End points were identified after 30 days, 90 days and 1 year postprocedure for evidence of GI bleeding or new onset anemia. Variables were compared between patients with and without GI bleeding using t test and Fisher exact test. Kaplan-Meier curve was constructed for estimating bleeding-free survival probability.
Results:
In a more than 1-year follow-up period, there were 39 cases (10.2%, 95% CI: 0.073-0.136) of documented GI bleeds. Females were found to have a significantly higher frequency of GI bleeding than males (16.8% vs. 8.0%, P = 0.018), and Hispanics more than non-Hispanics (11.7% vs. 1.7%, P = 0.017). All patients with GI bleeding survived at 1 year.
Conclusion:
In our study of a predominantly Hispanic population, a high incidence of GI bleeding after PCI occurred. However, there was no association between the incidence of GI bleeding and all-cause mortality, whether PCI was performed in the setting of acute coronary syndrome or as an elective procedure. There is a need to conduct a larger prospective study to validate the findings of our study.
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