Key result
Female sex is linked to ~18% lower odds of GI bleeding versus males in CVD.
Why the study?
Gastrointestinal bleeding is a serious complication among patients with cardiovascular disease, but sex differences in the odds of GI bleeding required evaluation.
Does female sex reduce the odds of gastrointestinal bleeding in adults with cardiovascular disease?
Case-Control (n=4,721)
Yes
Does female sex reduce the odds of gastrointestinal bleeding in adults with cardiovascular disease?
Among patients with cardiovascular disease, female sex is independently associated with a lower risk of gastrointestinal bleeding compared to male sex.
May refine sex-specific GI bleeding risk models in cardiovascular disease; leaves open causality and requires prospective validation.
OBJECTIVE: Gastrointestinal (GI) bleeding is a serious complication among patients with cardiovascular disease (CVD). This study aimed to evaluate sex differences in the odds of GI bleeding. METHODS: We analyzed data from an international case-control study of adults with CVD (n = 4721; 1807 women and 2914 men), conducted between September 3, 2015, and December 20, 2022. Cases presented with overt GI bleeding; controls had no prior GI bleeding. Baseline characteristics were compared by sex. Sequential multivariable logistic regression was used to assess the association between sex and GI bleeding, followed by sex-stratified analyses and tests for sex×factor interactions. RESULTS: Female sex was independently associated with lower adjusted odds of GI bleeding compared with male sex (aOR 0.82, 95% CI 0.72-0.95). While most established factors were associated with GI bleeding in both sexes, Coronary artery disease was associated with higher odds of GI bleeding only in women (aOR 1.44; P-interaction = 0.004). CONCLUSIONS: Among patients with CVD, female sex is independently associated with lower odds of GI bleeding. Several factors were shared between sexes, although some sex-specific associations were observed.
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Cai et al. (2026) conducted a case-control in Cardiovascular disease (n=4,721). Female sex vs. Male sex was evaluated on Gastrointestinal bleeding (aOR 0.82, 95% CI 0.72-0.95). Among patients with cardiovascular disease, female sex was independently associated with lower odds of gastrointestinal bleeding compared with male sex (aOR 0.82; 95% CI 0.72-0.95).
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