Major adverse upper gastrointestinal events in patients with ST-segment elevation myocardial infarction undergoing primary coronary intervention and dual antiplatelet therapy

Y.-L. Chen, C.-L. Chang, H.-C. Chen, C.-K. Sun, K.-H. Yeh, T.-H. Tsai, C.-J. Chen, S.-M. Chen, Chih-wei Yang, C.-L. Hang, C.-J. Wu, H.-K. Yip

Research output: Contribution to journalJournal Article peer-review

15 Scopus citations

Abstract

The aim of this study was to investigate the incidence of composite short-term and long-term major adverse upper gastrointestinal (UGI) events (MAUGIEs; defined as gastric ulcer, duodenal ulcer, gastroduodenal ulcer, or UGI bleeding) in patients with acute ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention and routinely received dual-antiplatelet therapy. From May 2002 to September 2010, a total of 1,368 consecutive patients who experienced ST-segment elevation myocardial infarction and underwent primary percutaneous coronary intervention were prospectively enrolled in the study. The incidence of in-hospital UGI bleeding complications and composite MAUGIEs was 8.9% and 9.9%, respectively. The in-hospital mortality rate was significantly higher in patients with in-hospital MAUGIEs than in those without (p <0.001). Multivariate analysis showed that age, advanced Killip score (≥3), and respiratory failure were the strongest independent predictors of in-hospital composite MAUGIEs (all p <0.003). The cumulative composite of MAUGIEs after uneventful discharge in patients without adverse UGI events who continuously received dual-antiplatelet therapy for 3 to 12 months, followed by aspirin therapy, was 10.4% during long-term (mean 4.0 years) follow-up. In conclusion, the results of this study show a remarkably high incidence of composite short-term and long-term MAUGIEs in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention and received routine dual-antiplatelet therapy. Age, advanced Killip score, and respiratory failure were significantly and independently predictive of in-hospital composite MAUGIEs. © 2011 Elsevier Inc. All rights reserved.
Original languageAmerican English
Pages (from-to)1704-1709
JournalAmerican Journal of Cardiology
Volume108
Issue number12
DOIs
StatePublished - 2011

Keywords

  • Aged
  • Angioplasty, Balloon, Coronary/adverse effects
  • Female
  • Gastrointestinal Diseases/epidemiology
  • Gastrointestinal Diseases/etiology
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction/physiopathology
  • Myocardial Infarction/therapy
  • Platelet Aggregation Inhibitors/adverse effects
  • Prospective Studies
  • Time Factors

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