Related Experiment Video
Updated: Jun 21, 2025
06:10
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
3.2K
A Closer Look into Gastrointestinal Bleeding in Heart Failure Patients
Anas Zaher1, Jude ElSaygh1, Akram Midani1
1New York Presbyterian-Brooklyn Methodist Hospital/ Weill Cornell Medicine, 506 6th street, Brooklyn, NY 11215, United States.
Current Problems in Cardiology
|July 7, 2024
Summary
Patients with heart failure with reduced ejection fraction (HFrEF) face a significant risk of gastrointestinal bleeding (GIB). Advanced age, elevated BNP levels, and use of anticoagulants/antiplatelets are key risk factors for GIB in this population.
Area of Science:
- Cardiology
- Gastroenterology
- Internal Medicine
Background:
- Gastrointestinal bleeding (GIB) risk and contributing factors in heart failure with reduced ejection fraction (HFrEF) patients remain under-researched.
- This study addresses the knowledge gap concerning GIB incidence and associated risk factors within the HFrEF demographic.
Purpose of the Study:
- To determine the frequency of GIB in HFrEF patients.
- To identify risk factors for GIB in this cohort.
- To analyze the utilization of antiplatelet and anticoagulation agents and examine endoscopic findings in HFrEF patients experiencing GIB.
Main Methods:
- A retrospective cohort study analyzed 670 patients with acute HFrEF between November 2021 and August 2023.
- Gastrointestinal bleeding (GIB) was identified via manual chart review of symptoms like hematemesis, melena, or hematochezia.
- Statistical analysis, including independent t-tests, compared patients with GIB (cases) to those without (controls).
Main Results:
- Out of 670 patients, 134 (20%) experienced GIB. Cases were older (median 77 vs. 70 years), had lower hemoglobin, and higher admission BNP levels compared to controls.
- Anticoagulant use was higher in cases (64%) versus controls (42%), and antiplatelet use was also more frequent in cases (68%) versus controls (52%).
- Upper endoscopy revealed higher rates of esophagitis, esophageal varices, gastritis, gastric ulcers, and duodenal ulcers in GIB patients. Colonoscopy showed increased prevalence of polyps and diverticulosis in the GIB group.
Conclusions:
- Heart failure patients exhibit an elevated risk of GIB.
- Advanced age and elevated BNP levels on admission are significant risk factors for GIB in HFrEF patients.
- While anticoagulant and antiplatelet use are associated with increased bleeding risk, combined therapies did not further elevate this risk. Common endoscopic findings include esophagitis, gastritis, ulcers, diverticulosis, and colonic masses.
More Related Videos
04:00Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
164
06:11Uncontrolled Hemorrhagic Shock Modeled via Liver Laceration in Mice with Real Time Hemodynamic Monitoring
Published on: May 21, 2017
8.6K
Related Concept Videos
01:28Esophageal Varices-II: Clinical Features and Management
57
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
57
01:24Esophageal Varices-I: Introduction
104
Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
104
01:29Gastroesophageal Reflux Disease II: Clinical Features and Management
68
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
68
01:23Gastritis III: Clinical Manifestations and Management
209
The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
209
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
160
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
160
01:17Pathophysiology of Heart Failure
1.5K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.5K