Author + information
- Saima Karim,
- Sweetheart Ador-Dionisio,
- Sadaf S. Khan,
- Munira Karim,
- Muhammad Imran,
- Ashish Atreja and
- Stephen Ellis
Little literature exists addressing the risk of performing percutaneous coronary intervention (PCI) in patients who have had recent gastrointestinal bleeding (GIB). This study analyzed mortality, re-infarction and further GIB rates among patients who had PCI within 30 days of a GIB event.
ICD-9 coding for acute GIB prior to cardiac catheterization was obtained for patients undergoing PCI from 2003 to 2009. These patients were compared to control patients undergoing PCI with no GIB. Baseline characteristics, lab values and outcomes were compared between the two groups. SAS 9.1 was used to perform the analysis.
There were 79 patients in the GIB arm and 10,979 patients in the control arm. Patients with GIB arm had a higher risk for both ischemic and bleeding events. There was no difference among the two groups regarding anti-platelet or anticoagulant use. The GIB patients were clinically more unstable upon presentation. 47% of the patients who had endoscopy for acute GIB had upper GIB. 20% of these patients needed endoscopic intervention. 20% of patients with GIB had recurrent episodes of GIB during follow up. Patients with GIB arm had greater morbidity, in hospital-mortality and long term mortality.
Overall, the patients who had GIB within 30 days preceding PCI not only had higher in-hospital mortality, but also higher long-term mortality. They also started to show a trend towards more frequent revascularization after a period of two years.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Bleeding and ACS: Predicting Risk and Measuring Impact
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1215M-200
- 2013 American College of Cardiology Foundation