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Gastrointestinal Bleeding After Percutaneous Coronary Intervention: Incidence, Risk Factors, and Outcomes

Ahmed Al-Hatmi1, Marwa Al-Habsi2, Malik Al-Ghafri2

  • 1Internal Medicine Training Program, Oman Medical Specialty Board, Muscat, OMN.

Cureus
|October 28, 2024
PubMed

Insights

Gastrointestinal bleeding (GIB) occurs in 3.4% of patients within a year after percutaneous coronary intervention (PCI). Advanced age and certain medical conditions are key risk factors for GIB post-PCI.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Clinical Medicine

Background:

  • Percutaneous coronary intervention (PCI) is a standard treatment for coronary artery disease.
  • PCI requires antiplatelet therapy, increasing the risk of gastrointestinal bleeding (GIB).
  • Understanding GIB incidence and causes post-PCI is crucial for patient management.

Purpose of the Study:

  • To determine the incidence, causes, and outcomes of GIB within one year following PCI.
  • To identify risk factors associated with GIB in patients undergoing PCI.
  • To inform preventative strategies for GIB in this patient population.

Main Methods:

  • Retrospective analysis of 435 patients undergoing PCI at Sultan Qaboos University Hospital (2017).
  • Gastrointestinal bleeding (GIB) defined using the thrombolysis in myocardial infarction (timi) bleeding score.
  • Binary logistic regression used to identify significant risk factors for GIB (p<0.05).

Main Results:

  • The incidence of GIB within one year post-PCI was 3.4% (15 patients).
  • Common presentations included melena (53.3%) and hematemesis (20.0%); peptic ulcer disease was the main cause (40%).
  • Significant risk factors for GIB were advanced age, chronic kidney disease, prior peptic ulcer disease, and NSAID use.

Conclusions:

  • The observed GIB incidence post-PCI is consistent with previous studies.
  • Pre-PCI risk stratification for bleeding is essential, particularly for high-risk individuals.
  • Consideration of prophylactic gastric protection is recommended to reduce GIB risk in PCI patients.
Abstract

Keywords:
acute gastrointestinal bleedantiplatelet agentspeptic ulcer diseasesprimary percutaneous coronary intervention (pci)risk factors

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