Key result
Prior duodenal ulcer is linked to ~6.6-fold higher GI bleeding risk on antiplatelet therapy.
Why the study?
Clinical and laboratory predictors of gastrointestinal bleeding in patients with coronary artery disease receiving antiplatelet therapy were not well defined.
Cohort (n=161)
No
Odds Ratio: 6.57 (95% CI 2.04–25.6)
p-value: p=0.003
In patients with coronary artery disease on antiplatelet therapy, smoking, H. pylori infection, history of duodenal ulcer, and metabolic/renal comorbidities independently predict a high risk of gastrointestinal bleeding.
Aim. To identify clinical and laboratory predictors of gastrointestinal bleeding in patients with coronary artery disease (CAD) receiving antiplatelet therapy. Materials and methods. A single-center cohort study was conducted, including 161 patients with CAD receiving antiplatelet therapy. The study group consisted of 55 patients with gastrointestinal bleeding (GIB), and the control group included 106 patients without GIB during the entire follow-up period. Demographic data, risk factors (smoking, diabetes mellitus, arterial hypertension), laboratory parameters [hemoglobin, creatinine, eGFR (by CKD-EPI formula), glucose, H. pylori status], and therapy data were collected retrospectively. Prospective follow-up (for 6 months) assessed erosive and ulcerative changes by esophagogastroduodenoscopy and the occurrence of GIB. Independent predictors were identified using multivariable logistic regression analysis. Results. The study included 161 patients with an established diagnosis of CAD receiving antiplatelet therapy. GIB was recorded in 55 (34.2%) patients. According to multivariable logistic regression analysis, independent predictors of GIB were: a history of duodenal ulcer (OR 6.57; p=0.005), smoking (OR 3.70; p=0.001), presence of pulmonary hypertension (OR 3.59; p=0.002), H. pylori infection (OR 3.41; p0.001), as well as elevated glucose levels (OR 1.28 per 1 mmol/L; p0.001) and creatinine levels (OR 1.02 per 1 μmol/L; p0.001). Conclusion. The identified predictors of GIB, including gastroenterological (duodenal ulcer history, H. pylori infection), behavioral factors (smoking), and comorbid conditions (hyperglycemia, elevated creatinine levels), can be used for risk stratification and timely effective prevention of GIB in patients with CAD receiving antiplatelet therapy.
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Deeva et al. (2026) conducted a cohort in Coronary artery disease (n=161). History of duodenal ulcer vs. No history of duodenal ulcer was evaluated on Gastrointestinal bleeding (OR 6.57, 95% CI 2.04-25.6, p=0.003). A history of duodenal ulcer significantly increased the risk of gastrointestinal bleeding (OR 6.57) in patients with coronary artery disease receiving antiplatelet therapy, alongside other predictors including H. pylori infection, smoking, pulmonary hypertension, and elevated glucose and creatinine levels.
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