In-hospital gastrointestinal bleeding in patients with acute myocardial infarction: incidence, outcomes and risk factors analysis from China Acute Myocardial Infarction Registry.
adult gastroenterology
health & safety
myocardial infarction
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
07 09 2021
07 09 2021
Historique:
entrez:
8
9
2021
pubmed:
9
9
2021
medline:
16
9
2021
Statut:
epublish
Résumé
To investigate the incidence of gastrointestinal bleeding (GIB) in patients with acute myocardial infarction (AMI), clarify the association between adverse clinical outcomes and GIB and identify risk factors for in-hospital GIB after AMI. Retrospective cohort study. 108 hospitals across three levels in China. From 1 January 2013 to 31 August 2014, after excluding 2659 patients because of incorrect age and missing GIB data, 23 794 patients with AMI from 108 hospitals enrolled in the China Acute Myocardial Infarction Registry were divided into GIB-positive (n=282) and GIB-negative (n=23 512) groups and were compared. Major adverse cardiovascular and cerebrovascular events (MACCEs) are a composite of all-cause death, reinfarction and stroke. The association between GIB and endpoints was examined using multivariate logistic regression and Cox proportional hazards models. Independent risk factors associated with GIB were identified using multivariate logistic regression analysis. The incidence of in-hospital GIB in patients with AMI was 1.19%. GIB was significantly associated with an increased risk of MACCEs both in-hospital (OR 2.314; p<0.001) and at 2-year follow-up (HR 1.407; p=0.0008). Glycoprotein IIb/IIIa (GPIIb/IIIa) receptor inhibitor, percutaneous coronary intervention (PCI) and thrombolysis were novel independent risk factors for GIB identified in the Chinese AMI population (p<0.05). GIB is associated with both in-hospital and follow-up MACCEs. Gastrointestinal prophylactic treatment should be administered to patients with AMI who receive primary PCI, thrombolytic therapy or GPIIb/IIIa receptor inhibitor. NCT01874691.
Identifiants
pubmed: 34493500
pii: bmjopen-2020-044117
doi: 10.1136/bmjopen-2020-044117
pmc: PMC8424832
doi:
Substances chimiques
Platelet Glycoprotein GPIIb-IIIa Complex
0
Banques de données
ClinicalTrials.gov
['NCT01874691']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e044117Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
J Crit Care. 2011 Aug;26(4):434.e1-6
pubmed: 21273036
Eur J Cardiothorac Surg. 2019 Jan 1;55(1):4-90
pubmed: 30165632
J Clin Gastroenterol. 2008 Apr;42(4):368-72
pubmed: 18277903
Eur Heart J. 2018 Jan 14;39(3):213-260
pubmed: 28886622
Circulation. 2011 Dec 6;124(23):e574-651
pubmed: 22064601
J Am Coll Cardiol. 2009 Sep 29;54(14):1293-302
pubmed: 19778672
J Thromb Thrombolysis. 2007 Feb;23(1):51-5
pubmed: 17186397
Circulation. 2010 Dec 14;122(24):2619-33
pubmed: 21060077
Circulation. 2011 Jun 14;123(23):2736-47
pubmed: 21670242
Circulation. 2009 Apr 14;119(14):1873-82
pubmed: 19332461
Eur Heart J. 2003 Oct;24(20):1815-23
pubmed: 14563340
Eur Heart J Acute Cardiovasc Care. 2012 Sep;1(3):222-31
pubmed: 24062910
Am J Crit Care. 2011 May;20(3):218-25
pubmed: 21532042
Am Heart J. 2016 May;175:193-201.e3
pubmed: 27179740
Am J Gastroenterol. 2008 Apr;103(4):865-71
pubmed: 18177451
Circulation. 2007 Feb 13;115(6):813-8
pubmed: 17224480
Am Heart J. 2011 Dec;162(6):1062-1068.e5
pubmed: 22137080
Am J Cardiol. 2011 Dec 15;108(12):1704-9
pubmed: 21924391
Catheter Cardiovasc Interv. 2012 Jan 1;79(1):104-12
pubmed: 22162411
JAMA. 2013 Mar 13;309(10):1022-9
pubmed: 23483177