Clinical Risk Factors for Upper Gastrointestinal Bleeding after Percutaneous Coronary Intervention: A Single-Center Study

Gut Liver. 2016 Jan;10(1):58-62. doi: 10.5009/gnl14127.

Abstract

Background/aims: Percutaneous coronary intervention (PCI) is often performed therapeutically, and antithrombotic treatment is required for at least 12 months after stent implantation. However, the development of post-PCI upper gastrointestinal bleeding (UGIB) increases morbidity and mortality. We investigated the incidence and risk factors for UGIB in Korean patients within 1 year after PCI.

Methods: The medical records of 3,541 patients who had undergone PCI between January 2006 and June 2012 were retrospectively reviewed. We identified 40 cases of UGIB. We analyzed the incidence and clinical risk factors associated with UGIB occurring within 1 year after PCI by comparing the results for each case to matched controls. The propensity score matching method using age and sex was utilized.

Results: UGIB occurred in 40 patients (1.1%). Two independent risk factors for UGIB were a history of peptic ulcer disease (odds ratio [OR], 12.68; 95% confidence interval [CI], 2.70 to 59.66; p=0.001) and the use of anticoagulants (OR, 7.76; 95% CI, 2.10 to 28.66; p=0.002).

Conclusions: UGIB after PCI occurred at a rate of 1.1% in the study population. Clinicians must remain vigilant for the possibility of UGIB after PCI and should consider performing timely endoscopy in patients who have undergone PCI and are suspected of having an UGIB.

Keywords: Esophagogastroduodenoscopy; Gastrointestinal hemorrhage; Percutaneous coronary intervention.

MeSH terms

  • Aged
  • Anticoagulants / adverse effects
  • Case-Control Studies
  • Female
  • Gastrointestinal Hemorrhage / epidemiology
  • Gastrointestinal Hemorrhage / etiology*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Peptic Ulcer / complications
  • Percutaneous Coronary Intervention / adverse effects*
  • Postoperative Complications*
  • Propensity Score
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Factors

Substances

  • Anticoagulants