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Risk factors for gastrointestinal bleeding in patients with cerebral infarction after dual antiplatelet therapy
Jiaming Huang1, Foqiang Liao2, Jianhua Tang1
1Department of Gastroenterology, Nanchang University Affiliated Ganzhou Hospital, Ganzhou, Jiangxi 341000, China.
Insights
Long-term aspirin use and severe cerebral infarction increase gastrointestinal bleeding risk in patients on dual antiplatelet therapy. Proton pump inhibitors (PPIs) offer protection against this bleeding.
Area of Science:
- Cardiology
- Neurology
- Gastroenterology
Background:
- Dual antiplatelet therapy (DAPT) is crucial for preventing secondary events in cerebral infarction patients.
- Gastrointestinal bleeding (GIB) is a significant complication associated with antiplatelet medications.
- Identifying risk factors for GIB in this vulnerable population is essential for optimizing patient care.
Purpose of the Study:
- To investigate the risk factors associated with gastrointestinal bleeding in patients with cerebral infarction who are undergoing dual antiplatelet therapy.
- To identify protective factors that may mitigate the risk of gastrointestinal bleeding in this patient cohort.
Main Methods:
- A retrospective study included 2370 patients with cerebral infarction receiving DAPT.
- Patients were divided into bleeding and non-bleeding groups.
- Propensity score matching and conditional logistic regression were employed to analyze risk factors.
Main Results:
- After propensity score matching, 85 patients were in each group.
- Long-term aspirin use and severity of cerebral infarction were identified as significant risk factors for GIB.
- The use of proton pump inhibitors (PPIs) demonstrated a protective effect against GIB.
Conclusions:
- Long-term aspirin use and cerebral infarction severity are key risk factors for GIB in patients on DAPT.
- Proton pump inhibitor (PPI) use is associated with a reduced risk of GIB, suggesting a prophylactic role.
Background:
To investigate the risk factors for gastrointestinal bleeding in patients with cerebral infarction after dual antiplatelet therapy.
Methods:
Cerebral infarction patients who received dual antiplatelet therapy during January 2019 and December 2021 in Nanchang University Affiliated Ganzhou Hospital were included. Patients were divided into a bleeding group and a nonbleeding group. Propensity score matching was used to match the data between the two groups. The risk factors for cerebral infarction with gastrointestinal bleeding after receiving dual antiplatelet therapy were analyzed by conditional logistic regression.
Results:
There were 2370 cerebral infarction patients who received dual antiplatelet therapy included in the study. There were significant differences between the bleeding group and the nonbleeding group in terms of sex, age, smoking, drinking, hypertension, coronary heart disease, diabetes and peptic ulcer before matching. After matching, 85 patients were included in the bleeding group and nonbleeding group, and there was no significant difference between the two groups in terms of sex, age, smoking, drinking, previous cerebral infarction, hypertension, coronary heart disease, diabetes, gout or peptic ulcer. Conditional logistic regression analysis showed that long-term use of aspirin and severity of cerebral infarction were risk factors for gastrointestinal bleeding in cerebral infarction patients receiving dual antiplatelet therapy, whereas the use of PPI was a protective factor against gastrointestinal bleeding.
Conclusions:
Long-term use of aspirin and severity of cerebral infarction are risk factors for gastrointestinal bleeding in cerebral infarction patients receiving dual antiplatelet therapy. The use of PPIs could reduce the risk of gastrointestinal bleeding.
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