Al-Hatmi Ahmed, Al-Habsi Marwa, Al-Ghafri Malik, Al-Siyabi Raiyan, Al-Ruheili Rinad, Nadar Sunil K, Al-Busafi Said A
Internal Medicine Training Program, Oman Medical Specialty Board, Muscat, OMN.
Clinical Physiology, Sultan Qaboos University Hospital, Muscat, OMN.
Cureus. 2024 Sep 26;16(9):e70248. doi: 10.7759/cureus.70248. eCollection 2024 Sep.
Percutaneous coronary intervention (PCI) is a well-established method for treating coronary artery disease. However, stent implantation necessitates the use of antiplatelet agents, which increases the risk of gastrointestinal bleeding (GIB). This study aims to assess the incidence, etiology, and outcomes of GIB within one year post-PCI at Sultan Qaboos University Hospital (SQUH), Muscat, Oman.
This retrospective analysis included 435 patients who underwent PCI at SQUH between January and December 2017, excluding those with multiple PCI procedures and incomplete data. GIB was defined using the thrombolysis in myocardial infarction (timi) bleeding score. Statistical analysis was performed using IBM SPSS Statistics for Windows, version 23 (IBM Corp., Armonk, NY) with binary logistic regression employed to identify significant risk factors for GIB. A p-value < 0.05 was considered statistically significant.
GIB was identified in 15 patients (age 67.8 ± 8.8 years; 60% male), resulting in an incidence within one year post-PCI of 3.4%. Melena (53.3%) and hematemesis (20.0%) were the most frequent clinical presentations, with peptic ulcer disease being the predominant underlying etiology (40%). Significant risk factors included advanced age, chronic kidney disease, pre-existing peptic ulcer disease, and the use of non-steroidal anti-inflammatory drugs.
The incidence of GIB observed in this study aligns with previously reported rates. These findings highlight the importance of pre-PCI risk stratification for bleeding, especially in high-risk patients. Prophylactic measures, such as the use of gastric protective agents, should be considered to mitigate the risk of GIB in patients undergoing PCI.
经皮冠状动脉介入治疗（PCI）是治疗冠状动脉疾病的一种成熟方法。然而，支架植入需要使用抗血小板药物，这会增加胃肠道出血（GIB）的风险。本研究旨在评估阿曼马斯喀特苏丹卡布斯大学医院（SQUH）PCI术后一年内GIB的发生率、病因及结局。
这项回顾性分析纳入了2017年1月至12月在SQUH接受PCI的435例患者，排除接受多次PCI手术及数据不完整的患者。GIB采用心肌梗死溶栓（timi）出血评分进行定义。使用IBM SPSS Statistics for Windows 23版（IBM公司，纽约州阿蒙克）进行统计分析，采用二元逻辑回归确定GIB的显著危险因素。p值<0.05被认为具有统计学意义。
15例患者（年龄67.8±8.8岁；60%为男性）被诊断为GIB，PCI术后一年内的发生率为3.4%。黑便（53.3%）和呕血（20.0%）是最常见的临床表现，消化性溃疡病是主要的潜在病因（40%）。显著的危险因素包括高龄、慢性肾脏病、既往消化性溃疡病以及使用非甾体类抗炎药。
本研究中观察到的GIB发生率与先前报道的发生率一致。这些发现凸显了PCI术前出血风险分层的重要性，尤其是在高危患者中。应考虑采取预防性措施，如使用胃保护剂，以降低接受PCI患者发生GIB的风险。
