Silent myocardial ischemia in coronary artery disease patients under aspirin therapy presenting with upper gastrointestinal hemorrhage

Abstract

Myocardial ischemia is a relatively common complication in CAD patients under aspirin therapy presenting with upper gastrointestinal hemorrhage. A history of CAD with triple vessel disease, higher blood urea nitrogen, lower diastolic blood pressure and lower hematocrit may help identify patients who are at increased risk of myocardial ischemia, which tends to be associated with higher in-hospital mortality and increased length of hospital stay.

Gastrointestinal bleeding in high risk survivors of myocardial infarction: the VALIANT Trial

“…Gastrointestinal (GI) bleeding is an important cause of morbidity and mortality in the general population as well as in patients with heart disease. 1,2 A recent analysis of patients undergoing primary percutaneous coronary intervention (PCI) for acute myocardial infarction (MI) found that GI bleeding was independently associated with an increased length of hospitalization and higher mortality. 3 Because the management of acute coronary syndromes (ACS) often necessitates the combined use of potent anti-platelet and anti-thrombotic medications, the potential risk of GI bleeding may be substantially increased in the ACS and post-MI populations.…”

Gastrointestinal bleeding: from conventional to nonconventional!

“…Hypotension before endoscopy and a high APACHE II score were found to be independent risk factors for complications in postmyocardial infarction patients. Chen et al [17] retrospectively attempted to identify risk factors for myocardial ischemia in patients with coronary artery disease who were on aspirin therapy and who presented with UGIB. A total of 152 patients (110 males) with a mean age of 70.8 9.8 were analyzed, and based upon the 12-lead electrocardiogram and cardiac enzyme findings were divided into two groups: Group A (myocardial ischemia, n = 31) and group B (nonmyocardial ischemia, n = 121).…”

Effect of cardiac rehabilitation on the nociceptive threshold increased of hypertensive subjects

“…Hypertension is considered to be a major risk factor for the development of coronary artery disease (CAD), and therefore, sudden cardiac death [2]. With regard to CAD, recent studies have shown that a silent ischemic infarction was a common manifestation in 50% of the subjects [3].…”