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Recent use of NSAID and NOAC medications are associated with a positive CT arteriogram

Muhammad A Shafqet1, Alexander Tonthat2, Paola Esparragoza3

  • 1Section of Gastroenterology and Hepatology, Lewis Katz School of Medicine at Temple University, 3401 North Broad Street, Philadelphia, PA, 19140, USA.

Abdominal Radiology (New York)
|April 6, 2019
PubMed

Insights

Novel oral anticoagulants (NOACs) and non-steroidal anti-inflammatory drugs (NSAIDs) predict positive computed tomography angiography (CTA) results in lower GI bleeding. CTA has a low risk of contrast-induced nephropathy.

Area of Science:

  • Gastroenterology
  • Radiology
  • Pharmacology

Background:

  • Computed tomography angiography (CTA) aids in diagnosing active lower gastrointestinal (GI) bleeding.
  • Clinical use of CTA is limited by contrast-induced nephropathy risk and patient monitoring challenges.
  • Identifying predictors of positive CTA results can optimize its clinical application.

Purpose of the Study:

  • To identify clinical predictors associated with positive CTA findings in patients with suspected lower GI bleeding.
  • To evaluate the association between specific medications and CTA positivity.
  • To assess the incidence of contrast-induced nephropathy during CTA for lower GI bleeding.

Main Methods:

  • Single-center retrospective study involving 262 patients.
  • Binary logistic regression modeling to identify independent predictors of positive CTA.
  • Analysis of medication use (NOACs, NSAIDs) prior to presentation.

Main Results:

  • 61 (23.3%) of CTA exams were positive.
  • Positive CTA was linked to higher intensive care unit (ICU) admission and in-hospital mortality.
  • Use of novel oral anticoagulants (NOACs) (aOR=3.89) and non-steroidal anti-inflammatory drugs (NSAIDs) (OR=2.36) in the prior week independently predicted positive CTA.
  • Contrast-induced nephropathy occurred in only 8% of patients.

Conclusions:

  • Novel oral anticoagulants (NOACs) and non-steroidal anti-inflammatory drugs (NSAIDs) are independently associated with positive CTA in acute lower GI bleeding.
  • CTA demonstrates a low risk of contrast-induced nephropathy in this patient cohort.
Abstract

Keywords:
Computed tomography angiographyContrast-induced nephropathyGastrointestinal bleeding

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