Impact of Prior Digestive System Disease on In-Hospital Gastrointestinal Bleeding in Patients with Acute Myocardial Infarction

Abstract

Objective: Patients presenting with acute myocardial infarction (AMI) with prior digestive system disease are more likely to suffer from gastrointestinal (GI) bleeding than those without these diseases. However, few articles reported how the different conditions of the digestive tract produced different risks of GI bleeding. Methods: A single-center study on 7464 patients admitted for AMI from December 2010 to June 2019 in the Beijing Chaoyang Heart Center was retrospectively examined. Patients with major GI bleeding (n = 165) were compared with patients without (n = 7299). Univariate and multivariate logistic regression models were constructed to test the association between GI bleeding and prior diseases of the digestive tract, including gastroesophageal reflux disease, chronic gastritis, peptic ulcer, hepatic function damage, diseases of the colon and rectum, and gastroenterological tract tumors. Results: Of the 7464 patients (mean age, 63.4; women, 25.6%; STEMI, 58.6%), 165 (2.2%) experienced major GI bleeding, and 1816 (24.3%) had a history of digestive system disease. The risk of GI bleeding was significantly associated with peptic ulcer (OR = 4.19, 95% CI: 1.86-9.45) and gastroenterological tumor (OR = 2.74, 95% CI: 1.07-7.04), indicated by multivariate logistic regression analysis. Conclusion: Preexisting peptic ulcers and gastroenterological tract tumors rather than other digestive system diseases were indicators of gastrointestinal bleeding in patients with AMI who undergo standard antithrombotic treatment during hospitalization.

Pre-existing Proton Pump Inhibitor Treatment and Short-Term Prognosis of Acute Myocardial Infarction Patients

“…Second, all the existing studies only investigated the safety of PPI use which was started after AMI had been established. Third, the benefit of using PPI for stress ulcer prophylaxis in critically ill settings may also apply to AMI patients ( 32 , 33 ), as stress ulcer and related gastrointestinal bleeding are not rare in AMI patients ( 34 ) and early use of PPI may benefit AMI patients by decreasing gastrointestinal bleeding ( 35 ). Fourth, both the trials and observational studies revealed that the use of PPI significantly reduced the risks of gastrointestinal bleeding when receiving dual antiplatelet therapy which was indicated for AMI ( 29 ).…”

General Explanation of Aspirin: Recent and Future Advancement

“…AIA is a disparate clinical syndrome expressed by adverse respiratory reactions to ASA and distinct NSAIDs [46]. ASA cause Intracerebral Hemorrhage owing to prolonged bleeding time [47]; Fatal airway obstruction in asthmatic patients/bronchospasm; Hypersensitivity [48,49]; hepatotoxicity and cardiovascular collapse; Blood and the lymphatic system disorders [50]; Renal and urinary disorders [51]; Skin and subcutaneous tissue disorders [52]; GI disorders owing to ASA inhibits, COX, which is accountable for generation of prostaglandins which protect GI mucosal layers [53]; Ear and labyrinth disorders [54].…”