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The Impact of Cardiac Dysfunction Based on Killip Classification on Gastrointestinal Bleeding in Acute Myocardial
Yu Liu1, De-Jing Feng1, Le-Feng Wang1
1Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Insights
Patients with acute myocardial infarction (AMI) and higher Killip class cardiac dysfunction face a significantly increased risk of gastrointestinal bleeding (GIB). This study highlights the link between heart function severity and bleeding complications.
Area of Science:
- Cardiology
- Gastroenterology
- Clinical Medicine
Background:
- Limited data exists on the association between cardiac dysfunction, classified by Killip, and gastrointestinal bleeding (GIB) in acute myocardial infarction (AMI) patients.
- Investigating this link is crucial for understanding bleeding risk in AMI patients with varying degrees of heart failure.
Purpose of the Study:
- To determine the impact of cardiac dysfunction, using the Killip classification, on the incidence of GIB in patients with AMI.
- To assess if higher Killip class (indicating more severe cardiac dysfunction) correlates with a higher risk of GIB.
Main Methods:
- A retrospective analysis of 6,458 patients with AMI admitted to a cardiac intensive care unit from December 2010 to June 2019.
- Data on GIB and Killip classification were extracted from discharge diagnoses using ICD-10 codes.
- Univariate and multivariate conditional logistic regression models were used to analyze the association between GIB and Killip classes.
Main Results:
- Gastrointestinal bleeding (GIB) was diagnosed in 131 out of 6,458 AMI patients (2.03%).
- Multivariate analysis revealed a significant correlation between cardiac dysfunction severity and GIB risk.
- Compared to Killip class 1, the odds ratios for GIB were 1.15 (95% CI: 0.73-1.08) for Killip class 2, 2.63 (95% CI: 1.44-4.81) for Killip class 3, and 4.33 (95% CI: 2.34-8.06) for Killip class 4.
Conclusions:
- The degree of cardiac dysfunction in acute myocardial infarction patients is closely associated with the risk of gastrointestinal bleeding.
- Patients classified in higher Killip classes (3 and 4) exhibit a substantially increased risk of developing GIB.
Background:
Owing to limited data, the effect of cardiac dysfunction categorized according to the Killip classification on gastrointestinal bleeding (GIB) in patients with acute myocardial infarction (AMI) is unclear. The present study aimed to investigate the impact of cardiac dysfunction on GIB in patients with AMI and to determine if patients in the higher Killip classes are more prone to it.
Methods:
This retrospective study was comprised of patients with AMI who were admitted to the cardiac intensive care unit in the Heart Center of the Beijing Chaoyang Hospital between December 2010 and June 2019. The in-hospital clinical data of the patients were collected. Both GIB and cardiac function, according to the Killip classification system, were confirmed using the discharge diagnosis of the International Classification of Diseases, Tenth Revision coding system. Univariate and multivariate conditional logistic regression models were constructed to test the association between GIB and the four Killip cardiac function classes.
Results:
In total, 6,458 patients with AMI were analyzed, and GIB was diagnosed in 131 patients (2.03%). The multivariate logistic regression analysis showed that the risk of GIB was significantly correlated with the cardiac dysfunction [compared with the Killip class 1, Killip class 2's odds ratio (OR) = 1.15, 95% confidence interval (CI): 0.73-1.08; Killip class 3's OR = 2.63, 95% CI: 1.44-4.81; and Killip class 4's OR = 4.33, 95% CI: 2.34-8.06].
Conclusion:
This study demonstrates that the degree of cardiac dysfunction in patients with acute myocardial infarction is closely linked with GIB. The higher Killip classes are associated with an increased risk of developing GIB.
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