TY - JOUR
T1 - Major adverse upper gastrointestinal events in patients with ST-segment elevation myocardial infarction undergoing primary coronary intervention and dual antiplatelet therapy
AU - Chen, Y.-L.
AU - Chang, C.-L.
AU - Chen, H.-C.
AU - Sun, C.-K.
AU - Yeh, K.-H.
AU - Tsai, T.-H.
AU - Chen, C.-J.
AU - Chen, S.-M.
AU - Yang, Chih-wei
AU - Hang, C.-L.
AU - Wu, C.-J.
AU - Yip, H.-K.
PY - 2011
Y1 - 2011
N2 - 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.
AB - 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.
KW - Aged
KW - Angioplasty, Balloon, Coronary/adverse effects
KW - Female
KW - Gastrointestinal Diseases/epidemiology
KW - Gastrointestinal Diseases/etiology
KW - Humans
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/physiopathology
KW - Myocardial Infarction/therapy
KW - Platelet Aggregation Inhibitors/adverse effects
KW - Prospective Studies
KW - Time Factors
U2 - 10.1016/j.amjcard.2011.07.039
DO - 10.1016/j.amjcard.2011.07.039
M3 - Journal Article
C2 - 21924391
SN - 0002-9149
VL - 108
SP - 1704
EP - 1709
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 12
ER -