Safety and utility of oesophago-gastro-duodenoscopy in acute myocardial infarction
AIMTo study the safety and utility of performing an oesophago-gastro-duodenoscopy (EGD) in the setting of an acute myocardial infarction (AMI). METHODSCase records of all patients who underwent an EGD for various indications within 4 weeks of an AMI between January 2001 and April 2006 were analyzed....
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| Veröffentlicht in: | European journal of gastroenterology & hepatology 2008-01, Vol.20 (1), p.51-55 |
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| container_title | European journal of gastroenterology & hepatology |
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| creator | Mumtaz, Khalid Wasim, Faisal Jafri, Wasim Abid, Shahab Hamid, Saeed Shah, Hasnain Dhakam, Sajid |
| description | AIMTo study the safety and utility of performing an oesophago-gastro-duodenoscopy (EGD) in the setting of an acute myocardial infarction (AMI).
METHODSCase records of all patients who underwent an EGD for various indications within 4 weeks of an AMI between January 2001 and April 2006 were analyzed. Demographic data, indications for endoscopy, outcomes and complications were noted. Main outcome measures included safety and utility of endoscopy in AMI.
RESULTSA total of 87 EGDs were performed on 85 patients with AMI. Seventy (83%) patients had a non-ST elevation MI, whereas 15 (17%) had ST elevation MI. Mean time between EGD and AMI was 6±1.8 days. Indications for EGD were hematemesis and/or melena on presentation in 38 (44.7%), hematemesis and/or melena post anticoagulation in 27 (31.8%). EGD findings were gastric ulcer/erosions in 30 (34%), oesophago-gastric varices in 20 (22%), erosive oesophagitis in 17 (20%) and duodenal ulcer in 11 (13%). Diagnostic yield of EGD was 88%. Endoscopic interventions were performed in 26 (30%) patients with high risk of bleeding lesion. There were no EGD-related mortality, whereas 14 patients re-bled. A total of 21 patients died, including 7/14 (50%) who re-bled, compared with 14/71 (19%) without rebleed (P=0.008). There were no EGD-related deaths. Fourteen patients were on mechanical ventilation and 6/14 (43%) of these died as compared with 15/88 (17%) who were not ventilated (P=0.027).
CONCLUSIONEGD is safe and useful in diagnosis and management of gastrointestinal hemorrhage in patients with AMI, and allows decisions about anticoagulation. Re-bleed and need for mechanical ventilation predicts poor outcome in these patients. |
| doi_str_mv | 10.1097/MEG.0b013e3282f16a3a |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70154513</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70154513</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3801-a01da64f7195f94f35aa4fc0542f23216d89373e40913d8bc130fab57cd12b213</originalsourceid><addsrcrecordid>eNpdkFtrFTEQgINY7LH6D0T2Rd_SziTZzeZRSq1CRWgVfFtmc-lZzdkck13K-fdGeqDiwzAXvpmBj7E3COcIRl98ubo-hxFQeil6EbAjSc_YBpWWvO16_ZxtwLSKdwZ_nLKXpfwEQC1Rv2Cn2IMBY3DDbu8o-OXQ0OyadZniVOsUmuRL2m_pPvF7KktO3K3J-TkVm_aHZpobsuvim90hWcpuolhngbJdpjS_YieBYvGvj_mMff949e3yE7_5ev358sMNt7IH5AToqFNBo2mDUUG2RCpYaJUIQgrsXG-kll6BQen60aKEQGOrrUMxCpRn7P3j3X1Ov1dflmE3FetjpNmntQwasFUtygqqR9DmVEr2YdjnaUf5MCAMf10O1eXwv8u69vZ4fx133j0tHeVV4N0RoGIphkyzncoTZwxoKf_5_5Di4nP5FdcHn4etp7hsBwBQQkvNBUD1UlteA1H-AZHZjd8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70154513</pqid></control><display><type>article</type><title>Safety and utility of oesophago-gastro-duodenoscopy in acute myocardial infarction</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Mumtaz, Khalid ; Wasim, Faisal ; Jafri, Wasim ; Abid, Shahab ; Hamid, Saeed ; Shah, Hasnain ; Dhakam, Sajid</creator><creatorcontrib>Mumtaz, Khalid ; Wasim, Faisal ; Jafri, Wasim ; Abid, Shahab ; Hamid, Saeed ; Shah, Hasnain ; Dhakam, Sajid</creatorcontrib><description>AIMTo study the safety and utility of performing an oesophago-gastro-duodenoscopy (EGD) in the setting of an acute myocardial infarction (AMI).
METHODSCase records of all patients who underwent an EGD for various indications within 4 weeks of an AMI between January 2001 and April 2006 were analyzed. Demographic data, indications for endoscopy, outcomes and complications were noted. Main outcome measures included safety and utility of endoscopy in AMI.
RESULTSA total of 87 EGDs were performed on 85 patients with AMI. Seventy (83%) patients had a non-ST elevation MI, whereas 15 (17%) had ST elevation MI. Mean time between EGD and AMI was 6±1.8 days. Indications for EGD were hematemesis and/or melena on presentation in 38 (44.7%), hematemesis and/or melena post anticoagulation in 27 (31.8%). EGD findings were gastric ulcer/erosions in 30 (34%), oesophago-gastric varices in 20 (22%), erosive oesophagitis in 17 (20%) and duodenal ulcer in 11 (13%). Diagnostic yield of EGD was 88%. Endoscopic interventions were performed in 26 (30%) patients with high risk of bleeding lesion. There were no EGD-related mortality, whereas 14 patients re-bled. A total of 21 patients died, including 7/14 (50%) who re-bled, compared with 14/71 (19%) without rebleed (P=0.008). There were no EGD-related deaths. Fourteen patients were on mechanical ventilation and 6/14 (43%) of these died as compared with 15/88 (17%) who were not ventilated (P=0.027).
CONCLUSIONEGD is safe and useful in diagnosis and management of gastrointestinal hemorrhage in patients with AMI, and allows decisions about anticoagulation. Re-bleed and need for mechanical ventilation predicts poor outcome in these patients.</description><identifier>ISSN: 0954-691X</identifier><identifier>EISSN: 1473-5687</identifier><identifier>DOI: 10.1097/MEG.0b013e3282f16a3a</identifier><identifier>PMID: 18090991</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Aged ; Biological and medical sciences ; Cardiology. Vascular system ; Coronary heart disease ; Digestive system. Abdomen ; Duodenoscopy - adverse effects ; Endoscopy ; Esophagoscopy - adverse effects ; Female ; Gastrointestinal Hemorrhage - complications ; Gastrointestinal Hemorrhage - surgery ; Gastroscopy - adverse effects ; Heart ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Myocardial Infarction - complications ; Recurrence ; Risk Factors</subject><ispartof>European journal of gastroenterology & hepatology, 2008-01, Vol.20 (1), p.51-55</ispartof><rights>2008 Lippincott Williams & Wilkins, Inc.</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3801-a01da64f7195f94f35aa4fc0542f23216d89373e40913d8bc130fab57cd12b213</citedby><cites>FETCH-LOGICAL-c3801-a01da64f7195f94f35aa4fc0542f23216d89373e40913d8bc130fab57cd12b213</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4023,27922,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19907333$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18090991$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mumtaz, Khalid</creatorcontrib><creatorcontrib>Wasim, Faisal</creatorcontrib><creatorcontrib>Jafri, Wasim</creatorcontrib><creatorcontrib>Abid, Shahab</creatorcontrib><creatorcontrib>Hamid, Saeed</creatorcontrib><creatorcontrib>Shah, Hasnain</creatorcontrib><creatorcontrib>Dhakam, Sajid</creatorcontrib><title>Safety and utility of oesophago-gastro-duodenoscopy in acute myocardial infarction</title><title>European journal of gastroenterology & hepatology</title><addtitle>Eur J Gastroenterol Hepatol</addtitle><description>AIMTo study the safety and utility of performing an oesophago-gastro-duodenoscopy (EGD) in the setting of an acute myocardial infarction (AMI).
METHODSCase records of all patients who underwent an EGD for various indications within 4 weeks of an AMI between January 2001 and April 2006 were analyzed. Demographic data, indications for endoscopy, outcomes and complications were noted. Main outcome measures included safety and utility of endoscopy in AMI.
RESULTSA total of 87 EGDs were performed on 85 patients with AMI. Seventy (83%) patients had a non-ST elevation MI, whereas 15 (17%) had ST elevation MI. Mean time between EGD and AMI was 6±1.8 days. Indications for EGD were hematemesis and/or melena on presentation in 38 (44.7%), hematemesis and/or melena post anticoagulation in 27 (31.8%). EGD findings were gastric ulcer/erosions in 30 (34%), oesophago-gastric varices in 20 (22%), erosive oesophagitis in 17 (20%) and duodenal ulcer in 11 (13%). Diagnostic yield of EGD was 88%. Endoscopic interventions were performed in 26 (30%) patients with high risk of bleeding lesion. There were no EGD-related mortality, whereas 14 patients re-bled. A total of 21 patients died, including 7/14 (50%) who re-bled, compared with 14/71 (19%) without rebleed (P=0.008). There were no EGD-related deaths. Fourteen patients were on mechanical ventilation and 6/14 (43%) of these died as compared with 15/88 (17%) who were not ventilated (P=0.027).
CONCLUSIONEGD is safe and useful in diagnosis and management of gastrointestinal hemorrhage in patients with AMI, and allows decisions about anticoagulation. Re-bleed and need for mechanical ventilation predicts poor outcome in these patients.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Coronary heart disease</subject><subject>Digestive system. Abdomen</subject><subject>Duodenoscopy - adverse effects</subject><subject>Endoscopy</subject><subject>Esophagoscopy - adverse effects</subject><subject>Female</subject><subject>Gastrointestinal Hemorrhage - complications</subject><subject>Gastrointestinal Hemorrhage - surgery</subject><subject>Gastroscopy - adverse effects</subject><subject>Heart</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Myocardial Infarction - complications</subject><subject>Recurrence</subject><subject>Risk Factors</subject><issn>0954-691X</issn><issn>1473-5687</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkFtrFTEQgINY7LH6D0T2Rd_SziTZzeZRSq1CRWgVfFtmc-lZzdkck13K-fdGeqDiwzAXvpmBj7E3COcIRl98ubo-hxFQeil6EbAjSc_YBpWWvO16_ZxtwLSKdwZ_nLKXpfwEQC1Rv2Cn2IMBY3DDbu8o-OXQ0OyadZniVOsUmuRL2m_pPvF7KktO3K3J-TkVm_aHZpobsuvim90hWcpuolhngbJdpjS_YieBYvGvj_mMff949e3yE7_5ev358sMNt7IH5AToqFNBo2mDUUG2RCpYaJUIQgrsXG-kll6BQen60aKEQGOrrUMxCpRn7P3j3X1Ov1dflmE3FetjpNmntQwasFUtygqqR9DmVEr2YdjnaUf5MCAMf10O1eXwv8u69vZ4fx133j0tHeVV4N0RoGIphkyzncoTZwxoKf_5_5Di4nP5FdcHn4etp7hsBwBQQkvNBUD1UlteA1H-AZHZjd8</recordid><startdate>200801</startdate><enddate>200801</enddate><creator>Mumtaz, Khalid</creator><creator>Wasim, Faisal</creator><creator>Jafri, Wasim</creator><creator>Abid, Shahab</creator><creator>Hamid, Saeed</creator><creator>Shah, Hasnain</creator><creator>Dhakam, Sajid</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><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>200801</creationdate><title>Safety and utility of oesophago-gastro-duodenoscopy in acute myocardial infarction</title><author>Mumtaz, Khalid ; Wasim, Faisal ; Jafri, Wasim ; Abid, Shahab ; Hamid, Saeed ; Shah, Hasnain ; Dhakam, Sajid</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3801-a01da64f7195f94f35aa4fc0542f23216d89373e40913d8bc130fab57cd12b213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Coronary heart disease</topic><topic>Digestive system. Abdomen</topic><topic>Duodenoscopy - adverse effects</topic><topic>Endoscopy</topic><topic>Esophagoscopy - adverse effects</topic><topic>Female</topic><topic>Gastrointestinal Hemorrhage - complications</topic><topic>Gastrointestinal Hemorrhage - surgery</topic><topic>Gastroscopy - adverse effects</topic><topic>Heart</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Myocardial Infarction - complications</topic><topic>Recurrence</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mumtaz, Khalid</creatorcontrib><creatorcontrib>Wasim, Faisal</creatorcontrib><creatorcontrib>Jafri, Wasim</creatorcontrib><creatorcontrib>Abid, Shahab</creatorcontrib><creatorcontrib>Hamid, Saeed</creatorcontrib><creatorcontrib>Shah, Hasnain</creatorcontrib><creatorcontrib>Dhakam, Sajid</creatorcontrib><collection>Pascal-Francis</collection><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>European journal of gastroenterology & hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mumtaz, Khalid</au><au>Wasim, Faisal</au><au>Jafri, Wasim</au><au>Abid, Shahab</au><au>Hamid, Saeed</au><au>Shah, Hasnain</au><au>Dhakam, Sajid</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety and utility of oesophago-gastro-duodenoscopy in acute myocardial infarction</atitle><jtitle>European journal of gastroenterology & hepatology</jtitle><addtitle>Eur J Gastroenterol Hepatol</addtitle><date>2008-01</date><risdate>2008</risdate><volume>20</volume><issue>1</issue><spage>51</spage><epage>55</epage><pages>51-55</pages><issn>0954-691X</issn><eissn>1473-5687</eissn><abstract>AIMTo study the safety and utility of performing an oesophago-gastro-duodenoscopy (EGD) in the setting of an acute myocardial infarction (AMI).
METHODSCase records of all patients who underwent an EGD for various indications within 4 weeks of an AMI between January 2001 and April 2006 were analyzed. Demographic data, indications for endoscopy, outcomes and complications were noted. Main outcome measures included safety and utility of endoscopy in AMI.
RESULTSA total of 87 EGDs were performed on 85 patients with AMI. Seventy (83%) patients had a non-ST elevation MI, whereas 15 (17%) had ST elevation MI. Mean time between EGD and AMI was 6±1.8 days. Indications for EGD were hematemesis and/or melena on presentation in 38 (44.7%), hematemesis and/or melena post anticoagulation in 27 (31.8%). EGD findings were gastric ulcer/erosions in 30 (34%), oesophago-gastric varices in 20 (22%), erosive oesophagitis in 17 (20%) and duodenal ulcer in 11 (13%). Diagnostic yield of EGD was 88%. Endoscopic interventions were performed in 26 (30%) patients with high risk of bleeding lesion. There were no EGD-related mortality, whereas 14 patients re-bled. A total of 21 patients died, including 7/14 (50%) who re-bled, compared with 14/71 (19%) without rebleed (P=0.008). There were no EGD-related deaths. Fourteen patients were on mechanical ventilation and 6/14 (43%) of these died as compared with 15/88 (17%) who were not ventilated (P=0.027).
CONCLUSIONEGD is safe and useful in diagnosis and management of gastrointestinal hemorrhage in patients with AMI, and allows decisions about anticoagulation. Re-bleed and need for mechanical ventilation predicts poor outcome in these patients.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>18090991</pmid><doi>10.1097/MEG.0b013e3282f16a3a</doi><tpages>5</tpages></addata></record> |
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| ispartof | European journal of gastroenterology & hepatology, 2008-01, Vol.20 (1), p.51-55 |
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| subjects | Aged Biological and medical sciences Cardiology. Vascular system Coronary heart disease Digestive system. Abdomen Duodenoscopy - adverse effects Endoscopy Esophagoscopy - adverse effects Female Gastrointestinal Hemorrhage - complications Gastrointestinal Hemorrhage - surgery Gastroscopy - adverse effects Heart Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Myocardial Infarction - complications Recurrence Risk Factors |
| title | Safety and utility of oesophago-gastro-duodenoscopy in acute myocardial infarction |
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