Aziz Fahad
Penn State Hershey Medical Center, 500 University Drive, MC, Hershey, PA 17033, USA. Email:
Cardiol Res. 2014 Feb;5(1):8-11. doi: 10.14740/cr322w. Epub 2014 Feb 27.
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.
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.
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.
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.
胃肠道出血是急性心肌梗死患者经皮冠状动脉介入治疗后的一种出血性并发症。本研究的目的是确定胃肠道出血的预测因素以及胃肠道出血对接受经皮冠状动脉介入治疗患者的影响。
84例接受直接经皮冠状动脉介入治疗的ST段抬高型心肌梗死/非ST段抬高型心肌梗死(STEMI/NSETMI)患者中有6例(7.1%)发生胃肠道出血。
单因素分析显示,发生胃肠道出血的患者既往胃肠道出血发生率显著更高(16.66%对8.6%,P<0.001)。就诊时Killip分级较高与胃肠道出血发生率较高相关(61%对18%,P<0.01)。使用质子泵抑制剂并未降低胃肠道出血风险。这些患者的胃肠道出血与经皮冠状动脉介入治疗后较高的死亡率和发病率相关。
尽管心肌梗死患者的胃肠道出血会显著增加死亡率和发病率,但既往胃肠道出血和较高的Killip分级与胃肠道出血发生率较高相关。胃肠道出血的高危患者在就诊时即可被识别。