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March 1, 2021Vascular Health and Risk ManagementOpen Access

The patient treated with priority endoscopy before PCI survived without complications, while the patient treated with PCI first died from massive bleeding.

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Why the study?

Modifications to current guidelines may further reduce in-hospital mortality and hospitalization costs in patients presenting simultaneously with STEMI and gastrointestinal bleeding.

Does priority endoscopy before PCI improve survival in patients with simultaneous STEMI and gastrointestinal bleeding?

Population

Patients with concomitant gastrointestinal bleeding and STEMI

Comparison

Priority endoscopy before PCI vs traditional ESC guideline approach with PCI first

Design

Case report comparison

Authors

JNJakub NożewskiGGGrzegorz GrześkMKMaria Kłopocka

Discussion

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Overview

Early endoscopy may improve outcomes in STEMI with GI bleed; leaves open need for RCTs before guideline changes.

Structured PICO

Does priority endoscopy before PCI improve survival in patients with simultaneous STEMI and gastrointestinal bleeding?

P
Population
Patients with concomitant ST-segment elevation myocardial infarction (STEMI) and gastrointestinal bleeding (n=2 implied)
I
Intervention
Priority endoscopy before percutaneous coronary intervention (PCI)
C
Comparator
Traditional approach with PCI first, followed by typical antiplatelet therapy, per ESC guidelines
O
Outcome
In-hospital mortality and complicationshard clinical

In patients with simultaneous STEMI and GI bleeding, prioritizing endoscopy before PCI may prevent fatal bleeding complications, challenging standard ACS guidelines.

Limitations

  • Ethical constraints prevent randomized controlled trials for this specific clinical scenario

Cite This Study

Nożewski et al. (2021) studied this question.

synapsesocial.com/papers/6a77f51598f24dbf64bdaa3bhttps://doi.org/10.2147/vhrm.s292253
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Management of patient with concomitant upper gastrointestinal bleeding and myocardial infarction: two cases report and literature review2024
  2. 2Gastrointestinal Bleeding and Outcomes After Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction2011 · 14 citations
  3. 3Gastrointestinal bleeding in patients with acute myocardial infarction: literature review2020 · 3 citations
  4. 4Complex Cardiovascular Management in an 80-Year-Old Female With Gastrointestinal Bleeds and Klatskin Tumor: A Case of ST-Elevation Myocardial Infarction (MI) Management Complicated by Severe Anemia and Post-MI Ventricular Septal Defect Development2024 · 1 citations
  5. 5Randomized Controlled Trial of Early Endoscopy for Upper Gastrointestinal Bleeding in Acute Coronary Syndrome Patients2022 · 2 citations