Key result
Prior GI bleeding linked to ~22-fold higher post-PCI GI bleeding risk in AMI.
Why the study?
Gastrointestinal bleeding is a hemorrhagic complication after PCI in patients with acute myocardial infarction, and predictors and impact of GI bleeding need to be determined.
What are the predictors of gastrointestinal bleeding in patients with STEMI/NSTEMI undergoing primary percutaneous coronary intervention?
Observational (n=84)
No
What are the predictors of gastrointestinal bleeding in patients with STEMI/NSTEMI undergoing primary percutaneous coronary intervention?
Odds Ratio: 22.1 (95% CI 5.61–86.89)
p-value: p=<0.001
Previous gastrointestinal bleeding and higher Killip class at presentation are significant predictors of gastrointestinal bleeding after primary PCI in patients with acute myocardial infarction.
Highlights post-PCI GI bleeding risk in AMI; hypothesis-generating and requires validation in larger prospective studies.
BACKGROUND: Gastrointestinal (GI) bleeding is a hemorrhagic complication after percutaneous coronary intervention in patients with acute myocardial infarction. The purpose of the study is to determine predictors of GI bleeding and impact of GI bleeding on the patients undergoing percutaneous coronary intervention. METHODS: GI bleeding occurred in 6 (7.1%) of 84 patients with STEMI/NSETMI (ST-segment elevated myocardial infarction/Non ST-segment elevated myocardial infarction) undergoing primary percutaneous coronary intervention. RESULTS: Univariate analysis demonstrates that patients with GI bleeding had a significantly higher previous GI bleeding (16.66% vs. 8.6%, P < 0.001). Higher Killip classification at presentation was associated with higher incidence of GI bleeding (61% vs. 18%, P < 0.01). The use of proton pump inhibitors did not reduce the risk of GI bleeding. The GI bleeding in these patients was associated with higher mortality and morbidity in the post percutaneous coronary intervention period. CONCLUSION: Although, GI bleeding in patients with MI significantly increases mortality and morbidity, previous GI bleeding and higher Killip class are associated with higher incidence of GI bleeding. High-risk patients for GI bleeding can be identified at presentation.
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Aziz ur Rehman Aziz (2014) conducted an observational in Acute myocardial infarction (STEMI/NSTEMI) undergoing PCI (n=84). Previous gastrointestinal bleeding vs. No previous gastrointestinal bleeding was evaluated on Gastrointestinal bleeding post-PCI (OR 22.1, 95% CI 5.61-86.89, p=<0.001). Previous gastrointestinal bleeding was a strong independent predictor of gastrointestinal bleeding after percutaneous coronary intervention in patients with acute myocardial infarction (OR 22.1).
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