Risk factors for gastrointestinal bleeding in patients after PCI:a Meta-analysis
FENG Haihuan
CHANG Shuangyin
HONG Siqi
FENG Xiaoyu
WU Xiaobing
Abstract：Objective:To systematically evaluate the risk factors for gastrointestinal bleeding after percutaneous coronary intervention(PCI).Methods:Publicly published case-control studies and cohort studies related to risk factors for gastrointestinal bleeding in patients after PCI were retrieved from CNKI,WanFang Database,VIP,CBM,the Cochrane Library,PubMed,EMbase,Ovid,EBDCO host,Web of Science,and other databases.The search period was up to April 2023.After literature screening,data extraction and quality evaluation,RevMan 5.2 was used for Meta-analysis.Results:A total of 16 articles were included in this study,involving 584,903 patients,and 10 risk factors and 1 protective factor were identified.Meta-analysis results showed that the risk factors for gastrointestinal bleeding in patients after PCI included age≥60 years(OR=1.27,95％CI 1.20-1.34,P＜0.000 01),smoking history(OR=1.33,95％CI 1.22-1.44,P＜0.000 01),hypertension history(OR=1.28,95％CI 1.18-1.40,P＜0.000 01),renal insufficiency(OR=2.33,95％CI 1.61-3.36,P＜0.000 01),previous history of gastrointestinal disease(OR=2.01,95％CI 1.47-2.75,P＜0.000 01),cardiogenic shock(OR=2.00,95％CI 1.53-2.60,P＜0.000 01),diagnosis of acute coronary syndrome(OR=2.90,95％CI 2.07-4.07,P＜0.000 01),thrombocytopenia(OR=2.97,95％CI 1.89-4.68,P＜0.000 01),baseline hemoglobin decline(OR=1.55,95％CI 1.23-1.94,P=0.000 2),and use of glycoprotein Ⅱ b/Ⅲ a inhibitors(OR=1.80,95％CI 1.40-2.30,P＜0.000 01).Protective factors for gastrointestinal bleeding in patients after PCI include the use of proton pump inhibitors(PPI)(OR=0.37,95％CI 0.24-0.56,P＜0.000 01).Conclusion:Available evidence suggests that multiple factors are associated with an increased risk of gastrointestinal bleeding after PCI.This study is helpful for clinical staff to identify high-risk groups as early as possible and take intervention measures to prevent the occurrence and progression of gastrointestinal bleeding.
Keywords：percutaneous coronary interventionPCIgastrointestinal bleedingrisk factorsMeta-analysisevidence-based nursing
Publication Date：2024-11-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 4011-4018 )