One Year Survival is not Affected by Gastrointestinal Bleeding After Percutaneous Coronary Interventions

Abstract Background/Aims Percutaneous coronary intervention (PCI) has been the main therapy in acute coronary syndromes (ACS) and early antithrombotic agents as well as one-year dual antiplatelet are required adjuvant therapy. However, the development of post-PCI gastrointestinal (GI) bleeding may i...

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Veröffentlicht in:The American journal of the medical sciences 2017-04, Vol.353 (4), p.381-386
Hauptverfasser: Ngamdu, Kyari Sumayin, MD, El Mallah, Wael, MD, PhD, Dwivedi, Alok, PhD, Rabab Mohsin, MD, Elhanafi, Sherif, MD, Jia, Yi, MD, PhD, Alvarado, Luis A., MS, Mukherjee, Debabrata, MD, Zuckerman, Marc J., MD
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container_end_page 386
container_issue 4
container_start_page 381
container_title The American journal of the medical sciences
container_volume 353
creator Ngamdu, Kyari Sumayin, MD
El Mallah, Wael, MD, PhD
Dwivedi, Alok, PhD
Rabab Mohsin, MD
Elhanafi, Sherif, MD
Jia, Yi, MD, PhD
Alvarado, Luis A., MS
Mukherjee, Debabrata, MD
Zuckerman, Marc J., MD
description Abstract Background/Aims Percutaneous coronary intervention (PCI) has been the main therapy in acute coronary syndromes (ACS) and early antithrombotic agents as well as one-year dual antiplatelet are required adjuvant therapy. However, the development of post-PCI gastrointestinal (GI) bleeding may increase all-cause mortality. We compared the characteristics and outcomes of patients with GI bleeding within one year after PCI with those who did not develop bleeding. Methods A retrospective cohort study was conducted using data from 384 PCI procedures performed between January 2011 and December 2013 at our hospital participating in the National Cardiovascular Data registry. Endpoints were identified after 30 days, 90 days, and one year post-procedure for evidence of GI bleeding or new onset anemia. Variables were compared between patients with and without GI bleeding using t-test and Fisher′s exact test. Kaplan Meier curve was constructed for estimating bleeding free survival probability. Results Over a one-year follow-up period, there were 39 cases (10.2%, 95% CI: 0.073–0.136) of documented GI bleeds. Females were found to have a significantly higher frequency of GI bleeding than males (16.8% vs. 8.0%, p=0.018), and Hispanics more than non-Hispanics (11.7% vs. 1.7%, p=0.017). All patients with GI bleeding survived at one-year. Conclusion In our study in a predominantly Hispanic population, a high incidence of GI bleeding after PCI occurred. However, there was no association between the incidence of GI bleeding and all-cause mortality, whether PCI was performed in the setting of ACS or as an elective procedure. There is a need to conduct a larger prospective study to validate the findings of our study.
doi_str_mv 10.1016/j.amjms.2017.01.017
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However, the development of post-PCI gastrointestinal (GI) bleeding may increase all-cause mortality. We compared the characteristics and outcomes of patients with GI bleeding within one year after PCI with those who did not develop bleeding. Methods A retrospective cohort study was conducted using data from 384 PCI procedures performed between January 2011 and December 2013 at our hospital participating in the National Cardiovascular Data registry. Endpoints were identified after 30 days, 90 days, and one year post-procedure for evidence of GI bleeding or new onset anemia. Variables were compared between patients with and without GI bleeding using t-test and Fisher′s exact test. Kaplan Meier curve was constructed for estimating bleeding free survival probability. Results Over a one-year follow-up period, there were 39 cases (10.2%, 95% CI: 0.073–0.136) of documented GI bleeds. Females were found to have a significantly higher frequency of GI bleeding than males (16.8% vs. 8.0%, p=0.018), and Hispanics more than non-Hispanics (11.7% vs. 1.7%, p=0.017). All patients with GI bleeding survived at one-year. Conclusion In our study in a predominantly Hispanic population, a high incidence of GI bleeding after PCI occurred. However, there was no association between the incidence of GI bleeding and all-cause mortality, whether PCI was performed in the setting of ACS or as an elective procedure. There is a need to conduct a larger prospective study to validate the findings of our study.</description><identifier>ISSN: 0002-9629</identifier><identifier>EISSN: 1538-2990</identifier><identifier>DOI: 10.1016/j.amjms.2017.01.017</identifier><identifier>PMID: 28317626</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Dual Antiplatelet therapy ; Female ; Gastrointestinal bleeding ; Gastrointestinal Hemorrhage - etiology ; Humans ; Internal Medicine ; Male ; Middle Aged ; Percutaneous coronary intervention ; Percutaneous Coronary Intervention - adverse effects ; Platelet Aggregation Inhibitors - therapeutic use ; Retrospective Studies ; Survival Rate</subject><ispartof>The American journal of the medical sciences, 2017-04, Vol.353 (4), p.381-386</ispartof><rights>2017 Southern Society for Clinical Investigation</rights><rights>Copyright © 2017 by the Southern Society for Clinical Investigation. Unauthorized reproduction of this article is prohibited.</rights><rights>Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4599-7085746a663b93f76d6200b25b5c1096c68d66d698fb1196c69bee1b0e0c81933</citedby><cites>FETCH-LOGICAL-c4599-7085746a663b93f76d6200b25b5c1096c68d66d698fb1196c69bee1b0e0c81933</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28317626$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ngamdu, Kyari Sumayin, MD</creatorcontrib><creatorcontrib>El Mallah, Wael, MD, PhD</creatorcontrib><creatorcontrib>Dwivedi, Alok, PhD</creatorcontrib><creatorcontrib>Rabab Mohsin, MD</creatorcontrib><creatorcontrib>Elhanafi, Sherif, MD</creatorcontrib><creatorcontrib>Jia, Yi, MD, PhD</creatorcontrib><creatorcontrib>Alvarado, Luis A., MS</creatorcontrib><creatorcontrib>Mukherjee, Debabrata, MD</creatorcontrib><creatorcontrib>Zuckerman, Marc J., MD</creatorcontrib><title>One Year Survival is not Affected by Gastrointestinal Bleeding After Percutaneous Coronary Interventions</title><title>The American journal of the medical sciences</title><addtitle>Am J Med Sci</addtitle><description>Abstract Background/Aims Percutaneous coronary intervention (PCI) has been the main therapy in acute coronary syndromes (ACS) and early antithrombotic agents as well as one-year dual antiplatelet are required adjuvant therapy. However, the development of post-PCI gastrointestinal (GI) bleeding may increase all-cause mortality. We compared the characteristics and outcomes of patients with GI bleeding within one year after PCI with those who did not develop bleeding. Methods A retrospective cohort study was conducted using data from 384 PCI procedures performed between January 2011 and December 2013 at our hospital participating in the National Cardiovascular Data registry. Endpoints were identified after 30 days, 90 days, and one year post-procedure for evidence of GI bleeding or new onset anemia. Variables were compared between patients with and without GI bleeding using t-test and Fisher′s exact test. Kaplan Meier curve was constructed for estimating bleeding free survival probability. Results Over a one-year follow-up period, there were 39 cases (10.2%, 95% CI: 0.073–0.136) of documented GI bleeds. Females were found to have a significantly higher frequency of GI bleeding than males (16.8% vs. 8.0%, p=0.018), and Hispanics more than non-Hispanics (11.7% vs. 1.7%, p=0.017). All patients with GI bleeding survived at one-year. Conclusion In our study in a predominantly Hispanic population, a high incidence of GI bleeding after PCI occurred. However, there was no association between the incidence of GI bleeding and all-cause mortality, whether PCI was performed in the setting of ACS or as an elective procedure. 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Unauthorized reproduction of this article is prohibited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201704</creationdate><title>One Year Survival is not Affected by Gastrointestinal Bleeding After Percutaneous Coronary Interventions</title><author>Ngamdu, Kyari Sumayin, MD ; El Mallah, Wael, MD, PhD ; Dwivedi, Alok, PhD ; Rabab Mohsin, MD ; Elhanafi, Sherif, MD ; Jia, Yi, MD, PhD ; Alvarado, Luis A., MS ; Mukherjee, Debabrata, MD ; Zuckerman, Marc J., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4599-7085746a663b93f76d6200b25b5c1096c68d66d698fb1196c69bee1b0e0c81933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Dual Antiplatelet therapy</topic><topic>Female</topic><topic>Gastrointestinal bleeding</topic><topic>Gastrointestinal Hemorrhage - etiology</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Percutaneous coronary intervention</topic><topic>Percutaneous Coronary Intervention - adverse effects</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Retrospective Studies</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ngamdu, Kyari Sumayin, MD</creatorcontrib><creatorcontrib>El Mallah, Wael, MD, PhD</creatorcontrib><creatorcontrib>Dwivedi, Alok, PhD</creatorcontrib><creatorcontrib>Rabab Mohsin, MD</creatorcontrib><creatorcontrib>Elhanafi, Sherif, MD</creatorcontrib><creatorcontrib>Jia, Yi, MD, PhD</creatorcontrib><creatorcontrib>Alvarado, Luis A., MS</creatorcontrib><creatorcontrib>Mukherjee, Debabrata, MD</creatorcontrib><creatorcontrib>Zuckerman, Marc J., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of the medical sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ngamdu, Kyari Sumayin, MD</au><au>El Mallah, Wael, MD, PhD</au><au>Dwivedi, Alok, PhD</au><au>Rabab Mohsin, MD</au><au>Elhanafi, Sherif, MD</au><au>Jia, Yi, MD, PhD</au><au>Alvarado, Luis A., MS</au><au>Mukherjee, Debabrata, MD</au><au>Zuckerman, Marc J., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>One Year Survival is not Affected by Gastrointestinal Bleeding After Percutaneous Coronary Interventions</atitle><jtitle>The American journal of the medical sciences</jtitle><addtitle>Am J Med Sci</addtitle><date>2017-04</date><risdate>2017</risdate><volume>353</volume><issue>4</issue><spage>381</spage><epage>386</epage><pages>381-386</pages><issn>0002-9629</issn><eissn>1538-2990</eissn><abstract>Abstract Background/Aims Percutaneous coronary intervention (PCI) has been the main therapy in acute coronary syndromes (ACS) and early antithrombotic agents as well as one-year dual antiplatelet are required adjuvant therapy. However, the development of post-PCI gastrointestinal (GI) bleeding may increase all-cause mortality. We compared the characteristics and outcomes of patients with GI bleeding within one year after PCI with those who did not develop bleeding. Methods A retrospective cohort study was conducted using data from 384 PCI procedures performed between January 2011 and December 2013 at our hospital participating in the National Cardiovascular Data registry. Endpoints were identified after 30 days, 90 days, and one year post-procedure for evidence of GI bleeding or new onset anemia. Variables were compared between patients with and without GI bleeding using t-test and Fisher′s exact test. Kaplan Meier curve was constructed for estimating bleeding free survival probability. Results Over a one-year follow-up period, there were 39 cases (10.2%, 95% CI: 0.073–0.136) of documented GI bleeds. Females were found to have a significantly higher frequency of GI bleeding than males (16.8% vs. 8.0%, p=0.018), and Hispanics more than non-Hispanics (11.7% vs. 1.7%, p=0.017). All patients with GI bleeding survived at one-year. Conclusion In our study in a predominantly Hispanic population, a high incidence of GI bleeding after PCI occurred. However, there was no association between the incidence of GI bleeding and all-cause mortality, whether PCI was performed in the setting of ACS or as an elective procedure. There is a need to conduct a larger prospective study to validate the findings of our study.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28317626</pmid><doi>10.1016/j.amjms.2017.01.017</doi><tpages>6</tpages></addata></record>
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subjects Aged
Dual Antiplatelet therapy
Female
Gastrointestinal bleeding
Gastrointestinal Hemorrhage - etiology
Humans
Internal Medicine
Male
Middle Aged
Percutaneous coronary intervention
Percutaneous Coronary Intervention - adverse effects
Platelet Aggregation Inhibitors - therapeutic use
Retrospective Studies
Survival Rate
title One Year Survival is not Affected by Gastrointestinal Bleeding After Percutaneous Coronary Interventions
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