Risk factors of cardiac ischemic events in patients with gastrointestinal bleeding after percutaneous coronary intervention

Yang Jinlong; Liu Huan; Luo Yuanlin; Zhou Xuefeng; Luo Yongquan; Liu Hongbo

doi:10.3969/j.issn.1674-4055.2017.12.25

Abstract：Objective To investigate the risk factors of cardiac ischemic events (CIE) in patients with upper gastrointestinal bleeding (UGIB) induced by dual anti-platelet therapy (DAPT) after percutaneous coronary intervention (PCI), and provide guidance for management the patients well.Methods The patients (n=117) with UGIB induced by DAPT after PCI were retrospectively analyzed, and divided, according to whether or not CIE onset, into CIE group (n=32) and non-CIE group (n=85). The clinical data was compared between 2 groups, and risk factors of CIE were analyzed in patients with UGIB induced by DAPT after PCI in duration of hospital stay.Results In 117 patients, there were 32 offered from CIE. Age, male, diabetes history, complicated heart failure, gastric ulcer history, DAPT time before bleeding, stopping time of DAPT after bleeding and clopidogrel used singly after bleeding all had statistical difference between 2 groups (P<0.05). The results of multi-factor regression analysis showed that age (OR=2.245, 95％CI:1.145～3.564), male (OR=1.148, 95％CI: 0.276～1.183), diabetes history (OR=2.227, 95％CI:1.274～3.284), complicated heart failure (OR=0.524, 95％CI: 0.311～0.837), gastric ulcer history (OR=0.651, 95％CI:0.329～1.417) and stopping time of DAPT after bleeding (OR=3.157, 95％CI: 1.462～8.917) were risk factors of CIE. Clopidogrel used singly after bleeding was a protective factor (OR=1.418, 95％CI: 1.216～1.635).Conclusion Age, male, diabetes history, complicated heart failure, gastric ulcer history and stopping DAPT after bleeding are risk factors of CIE, and clopidogrel used singly after bleeding is a protective factor in patients with UGIB induced by DAPT after PCI, which provides good reference for management of this kind of patients.