Risk factors of upper gastrointestinal bleeding caused by dual antiplatelet therapy with aspirin and clopidogrel after percutaneous coronary intervention
Liu Ying
You Jialu
Shi Jin
Zhang Jie
Abstract：Objective To investigate risk factors of upper gastrointestinal bleeding caused by dual antiplatelet therapy(DAPT) after percutaneous coronary intervention(PCI).Methods Totally 1263 patients who had underwent PCI from January 2012 to July 2012 in Beijing Anzhen Hospital,Capital Medical University were retrospectively analyzed.All patients were given aspirin enteric-coated tablets(100mg/time,1 time/d)and clopidogrel sulfate tablets (75mg/time,1 time/d).The postoperative follow-up lasted for 6 months.Gender;age;histories of hypertension,diabetes mellitus,thrombotic disease,heart failure,gastrointestinal bleeding,smoking,drinking;family history of digestive tract disease;postoperative application of heparin;heart rate;systolic blood pressure;CRUSADE bleeding score;Killip classification of cardiac function;preoperative values of hemoglobin concentration,hematocrit,platelet concentration,creatinine clearance rate,platelet aggregation rate and fasting blood glucose were recorded.Occurrences of upper gastrointestinal bleeding were observed.Multivariate logistic regression was used to analyze risk factors of upper gastrointestinal bleeding caused by DAPT after PCI.Results Totally 52 cases (4.1％)had upper gastrointestinal bleeding.Gender[odds ratio(OR):0.323,95％ confidence interval (CI):0.130-0.802];age(OR:1.026,95％ CI:0.990-1.063);history of thrombotic disease(OR:2.522,95％ CI:1.093-5.820);history of gastrointestinal bleeding(OR:8.704,95％ CI:3.292-23.012);family history of digestive tract disease (OR:2.253,95％ CI:1.147-4.426);postoperative application of heparin (OR:0.323,95％ CI:0.174-0.606);heart rate (OR:1.038,95％ CI:1.004-1.074);CRUSADE bleeding score (OR:1.775,95％ CI:1.141-2.764);Killip classification of cardiac function(OR:1.700,95％ CI:1.011-2.857);preoperative hemoglobin concentration(OR:0.911,95％ CI:0.872-0.952),hematocrit(OR:1.397,95％ CI:120-1.627),creatinine clearance rate(OR:0.988,95％ CI:0.977-1.000),platelet aggregation rate (OR:0.957,95 ％ CI:0.941-0.973) and fasting blood glucose (OR:121.1,95 ％ CI:1.078-136) were risk factors of upper gastrointestinal bleeding caused by DAPT after PCI (P ＜ 0.05 or P ＜ 0.01).Conclusion Male;advanced age;history of thrombotic disease;history of gastrointestinal bleeding;family history of digestive tract disease;postoperative application of heparin;rapid heart rate;high CRUSADE score;high Killip classification of cardiac function;low levels of preoperative hemoglobin concentration,hematocrit,creatinine clearance rate,platelet aggregation rate and high level of fasting blood glucose are risk factors of upper gastrointestinal bleeding in patients treated by DAPT after PCI.
Keywords：Percutaneous coronary interventionAspirinClopidogrelAntiplateletUpper gastrointestinal bleedingRisk factor
Publication Date：2016-07-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1022-1026 )