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Sex differences in gastrointestinal bleeding among patients with cardiovascular diseases: A secondary analysis of the

Yaoyao Cai1, Jacqueline Bosch2, Jun Zhu1

  • 1Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Thrombosis Research
|May 14, 2026
PubMed

Insights

Gastrointestinal bleeding is less likely in women with cardiovascular disease (CVD). However, coronary artery disease increases bleeding risk specifically in women, highlighting sex-specific factors in CVD patients.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Epidemiology

Background:

  • Gastrointestinal (GI) bleeding is a significant complication in patients with cardiovascular disease (CVD).
  • Understanding sex differences in GI bleeding risk is crucial for targeted prevention and management strategies.

Purpose of the Study:

  • To evaluate potential sex-based disparities in the likelihood of experiencing GI bleeding among individuals with CVD.
  • To identify sex-specific risk factors associated with GI bleeding in this patient population.

Main Methods:

  • An international case-control study involving 4721 adults with CVD (1807 women, 2914 men) was conducted.
  • Data were analyzed using sequential multivariable logistic regression to assess the association between sex and GI bleeding, including sex-stratified analyses and interaction tests.

Main Results:

  • Female sex was independently linked to reduced adjusted odds of GI bleeding compared to male sex (aOR 0.82, 95% CI 0.72-0.95).
  • Coronary artery disease showed an association with increased GI bleeding odds exclusively in women (aOR 1.44; P-interaction = 0.004).

Conclusions:

  • Female patients with CVD exhibit a lower independent risk of GI bleeding.
  • While many risk factors for GI bleeding are common across sexes, specific associations, such as coronary artery disease with bleeding risk in women, were identified.
Abstract

Keywords:
Associated factorsCardiovascular diseasesCase-control studiesGastrointestinal hemorrhageSex factors

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