Key result
Older age linked to ~5% higher risk of recurrent upper GI bleeding on DAPT.
Why the study?
Patients undergoing DAPT may experience recurrent gastrointestinal bleeding, but the clinical characteristics and risk factors for recurrent NVUGIB in this population remained to be investigated.
Cohort (n=124)
No
Odds Ratio: 1.05 (95% CI 1.001–1.102)
p-value: p=0.047
In patients experiencing upper GI bleeding while on dual antiplatelet therapy, older age (particularly >70 years) is a significant independent predictor of recurrent bleeding and bleeding-related mortality.
Age was associated with recurrent bleeding on DAPT after upper GI bleed; hypothesis-generating for age-stratified risk assessment in prospective cohorts.
Background: Patients undergoing dual antiplatelet therapy (DAPT) may experience recurrent gastrointestinal bleeding (GIB). We investigated the clinical characteristics and risk factors for recurrent non-variceal upper gastrointestinal bleeding (NVUGIB) in patients who had experienced NVUGIB while receiving DAPT. Methods: We enrolled patients diagnosed with NVUGIB while receiving DAPT between 2006 and 2020. Definite bleeding was confirmed by esophagogastroduodenoscopy in all NVUGIB patients. Results: A total of 124 patients were diagnosed with NVUGIB while receiving DAPT. They were predominantly male (n = 103, 83.1%), bleeding mostly from the stomach (n = 94, 75.8%) and had peptic ulcers (n = 72, 58.1%). After the successful hemostasis of NVUGIB, 36 patients (29.0%) experienced at least one episode of recurrent upper GIB, 19 patients (15.3%) died, and 7 (5.6%) patients had a bleeding-related death. Multivariate analysis showed that age was a significant factor for re-bleeding (odds ratio [OR], 1.050; 95% confidence interval [CI]: 1.001–1.102; p-value: 0.047), all-cause mortality (OR, 1.096; 95% CI: 1.020–1.178, p = 0.013), and re-bleeding-related mortality (OR, 1.187; 95% CI: 1.032–1.364, p-value: 0.016). In Kaplan–Meier analysis, the cumulative probabilities of re-bleeding, death, and bleeding-related death were significantly higher in patients aged 70 and older (p = 0.008, <0.001, and 0.009, respectively). Conclusions: Clinicians should be cautious about re-bleeding and mortality in elderly patients who experience NVUGIB while receiving DAPT.
No takes yet. Share an insight, caveat, or question.
Yoo et al. (2023) conducted a cohort in Non-variceal upper gastrointestinal bleeding (NVUGIB) on dual antiplatelet therapy (n=124). Age (per 1-year increase) was evaluated on Recurrent non-variceal upper gastrointestinal bleeding (re-bleeding) (OR 1.050, 95% CI 1.001-1.102, p=0.047). Increasing age was significantly associated with a higher risk of recurrent non-variceal upper gastrointestinal bleeding (OR 1.050, p=0.047) among patients on dual antiplatelet therapy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: