Incidence of Endoscopic Findings and Related Risk Factors in Patients with Gastrointestinal Bleeding after Percutaneous Coronary Intervention and Combination Antiplatelet Therapy

Abstract

Background:

Combination antiplatelet therapy is a classic treatment for percutaneous coronary intervention (PCI) but this therapy increases gastrointestinal bleeding (GIB). This study highlights the incidence of related risk factors of GIB and endoscopic findings in patients with GIB after PCI and combination antiplatelet therapy.

Materials and Methods:

A standard check list was used to evaluate the significant risk factors of GIB and upper endoscopic findings in combination antiplatelet treated patients after PCI in the GI center of Rajai Hospital- Karaj, Iran. All statistical tests were performed using SPSS software version 22.0.

Results:

During a 12-month period, a total of 103 patients with a mean age of 63 years were included.  64 patients were admitted to hospital and 39 patients were visited in the GI clinic. 54.4 % of the patients were male. The patients’ symptoms were melena (82.5%),  hematemesis (28.1%), and hematochezia 3.9%).  6.8% of the patients were admitted with severe GIB and unstable conditions. Findings of upper endoscopy (n=82) were duodenal ulcer (63.4%), gastric ulcer (37.8 %), hiatal hernia (23.2%), Mallory Weiss syndrome (13.4%),  gastric tumor (3.7%), and esophageal hematoma (2.4%). Normal endoscopic finding was seen in 14.6% of the patients who had history of GIB. Rapid urease test was positive in 46.3% of the patients. 12.6% of the patients died during hospital admission.

Conclusions:

The high prevalence of GIB risk factors were seen among combination antiplatelet treated patients. By identifying and control of such risk factors, GIB in patients receiving combination antiplatelet therapy can be minimized.