Impact of Prior Digestive System Disease on In-Hospital Gastrointestinal Bleeding in Patients with Acute Myocardial
Yu Liu1, Le-Feng Wang1, Li-Hong Liu1
1Heart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China.
Insights
Patients with acute myocardial infarction (AMI) and a history of peptic ulcers or gastrointestinal tumors face a higher risk of bleeding. Other digestive diseases did not show a significant association with gastrointestinal bleeding in AMI patients.
Area of Science:
- Cardiology
- Gastroenterology
- Internal Medicine
Background:
- Patients with acute myocardial infarction (AMI) and pre-existing digestive system diseases have an increased risk of gastrointestinal (GI) bleeding.
- Limited research exists on how specific digestive tract conditions influence GI bleeding risk in AMI patients.
Purpose of the Study:
- To investigate the association between various pre-existing digestive system diseases and the risk of GI bleeding in patients admitted for AMI.
- To identify specific digestive conditions that serve as indicators for GI bleeding in this patient population.
Main Methods:
- Retrospective analysis of 7464 patients admitted for AMI between December 2010 and June 2019.
- Comparison of patients with major GI bleeding (n=165) against those without (n=7299).
- Logistic regression models used to assess the link between GI bleeding and digestive diseases like GERD, gastritis, peptic ulcer, liver damage, colon/rectal diseases, and GI tumors.
Main Results:
- 2.2% of AMI patients experienced major GI bleeding; 24.3% had a history of digestive disease.
- Multivariate analysis revealed a significant association between GI bleeding and peptic ulcer (OR=4.19) and gastroenterological tumors (OR=2.74).
- Other digestive diseases, including GERD, gastritis, liver damage, and colon/rectal diseases, were not significantly associated with increased GI bleeding risk.
Conclusions:
- Pre-existing peptic ulcers and gastroenterological tumors are significant indicators of GI bleeding risk in AMI patients.
- These findings are relevant for patients undergoing standard antithrombotic treatment during hospitalization for AMI.
- Risk stratification for GI bleeding in AMI patients should consider specific digestive conditions like peptic ulcers and tumors.
Objective:
Patients presenting with acute myocardial infarction (AMI) with prior digestive system disease are more likely to suffer from gastrointestinal (GI) bleeding than those without these diseases. However, few articles reported how the different conditions of the digestive tract produced different risks of GI bleeding.
Methods:
A single-center study on 7464 patients admitted for AMI from December 2010 to June 2019 in the Beijing Chaoyang Heart Center was retrospectively examined. Patients with major GI bleeding (n = 165) were compared with patients without (n = 7299). Univariate and multivariate logistic regression models were constructed to test the association between GI bleeding and prior diseases of the digestive tract, including gastroesophageal reflux disease, chronic gastritis, peptic ulcer, hepatic function damage, diseases of the colon and rectum, and gastroenterological tract tumors.
Results:
Of the 7464 patients (mean age, 63.4; women, 25.6%; STEMI, 58.6%), 165 (2.2%) experienced major GI bleeding, and 1816 (24.3%) had a history of digestive system disease. The risk of GI bleeding was significantly associated with peptic ulcer (OR = 4.19, 95% CI: 1.86-9.45) and gastroenterological tumor (OR = 2.74, 95% CI: 1.07-7.04), indicated by multivariate logistic regression analysis.
Conclusion:
Preexisting peptic ulcers and gastroenterological tract tumors rather than other digestive system diseases were indicators of gastrointestinal bleeding in patients with AMI who undergo standard antithrombotic treatment during hospitalization.
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