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Recurrent Non-Variceal Upper Gastrointestinal Bleeding among Patients Receiving Dual Antiplatelet Therapy

Background: Patients undergoing dual antiplatelet therapy (DAPT) may experience recurrent gastrointestinal bleeding (GIB). We investigated the clinical characteristics and risk factors for recurrent non-variceal upper gastrointestinal bleeding (NVUGIB) in patients who had experienced NVUGIB while re...

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Autores principales: Yoo, Ah Young, Joo, Moon Kyung, Park, Jong-Jae, Lee, Beom Jae, Kim, Seung Han, Kim, Won Shik, Chun, Hoon Jai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10670490/
https://www.ncbi.nlm.nih.gov/pubmed/37998579
http://dx.doi.org/10.3390/diagnostics13223444
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author Yoo, Ah Young
Joo, Moon Kyung
Park, Jong-Jae
Lee, Beom Jae
Kim, Seung Han
Kim, Won Shik
Chun, Hoon Jai
author_facet Yoo, Ah Young
Joo, Moon Kyung
Park, Jong-Jae
Lee, Beom Jae
Kim, Seung Han
Kim, Won Shik
Chun, Hoon Jai
author_sort Yoo, Ah Young
collection PubMed
description Background: Patients undergoing dual antiplatelet therapy (DAPT) may experience recurrent gastrointestinal bleeding (GIB). We investigated the clinical characteristics and risk factors for recurrent non-variceal upper gastrointestinal bleeding (NVUGIB) in patients who had experienced NVUGIB while receiving DAPT. Methods: We enrolled patients diagnosed with NVUGIB while receiving DAPT between 2006 and 2020. Definite bleeding was confirmed by esophagogastroduodenoscopy in all NVUGIB patients. Results: A total of 124 patients were diagnosed with NVUGIB while receiving DAPT. They were predominantly male (n = 103, 83.1%), bleeding mostly from the stomach (n = 94, 75.8%) and had peptic ulcers (n = 72, 58.1%). After the successful hemostasis of NVUGIB, 36 patients (29.0%) experienced at least one episode of recurrent upper GIB, 19 patients (15.3%) died, and 7 (5.6%) patients had a bleeding-related death. Multivariate analysis showed that age was a significant factor for re-bleeding (odds ratio [OR], 1.050; 95% confidence interval [CI]: 1.001–1.102; p-value: 0.047), all-cause mortality (OR, 1.096; 95% CI: 1.020–1.178, p = 0.013), and re-bleeding-related mortality (OR, 1.187; 95% CI: 1.032–1.364, p-value: 0.016). In Kaplan–Meier analysis, the cumulative probabilities of re-bleeding, death, and bleeding-related death were significantly higher in patients aged 70 and older (p = 0.008, <0.001, and 0.009, respectively). Conclusions: Clinicians should be cautious about re-bleeding and mortality in elderly patients who experience NVUGIB while receiving DAPT.
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spelling pubmed-106704902023-11-14 Recurrent Non-Variceal Upper Gastrointestinal Bleeding among Patients Receiving Dual Antiplatelet Therapy Yoo, Ah Young Joo, Moon Kyung Park, Jong-Jae Lee, Beom Jae Kim, Seung Han Kim, Won Shik Chun, Hoon Jai Diagnostics (Basel) Article Background: Patients undergoing dual antiplatelet therapy (DAPT) may experience recurrent gastrointestinal bleeding (GIB). We investigated the clinical characteristics and risk factors for recurrent non-variceal upper gastrointestinal bleeding (NVUGIB) in patients who had experienced NVUGIB while receiving DAPT. Methods: We enrolled patients diagnosed with NVUGIB while receiving DAPT between 2006 and 2020. Definite bleeding was confirmed by esophagogastroduodenoscopy in all NVUGIB patients. Results: A total of 124 patients were diagnosed with NVUGIB while receiving DAPT. They were predominantly male (n = 103, 83.1%), bleeding mostly from the stomach (n = 94, 75.8%) and had peptic ulcers (n = 72, 58.1%). After the successful hemostasis of NVUGIB, 36 patients (29.0%) experienced at least one episode of recurrent upper GIB, 19 patients (15.3%) died, and 7 (5.6%) patients had a bleeding-related death. Multivariate analysis showed that age was a significant factor for re-bleeding (odds ratio [OR], 1.050; 95% confidence interval [CI]: 1.001–1.102; p-value: 0.047), all-cause mortality (OR, 1.096; 95% CI: 1.020–1.178, p = 0.013), and re-bleeding-related mortality (OR, 1.187; 95% CI: 1.032–1.364, p-value: 0.016). In Kaplan–Meier analysis, the cumulative probabilities of re-bleeding, death, and bleeding-related death were significantly higher in patients aged 70 and older (p = 0.008, <0.001, and 0.009, respectively). Conclusions: Clinicians should be cautious about re-bleeding and mortality in elderly patients who experience NVUGIB while receiving DAPT. MDPI 2023-11-14 /pmc/articles/PMC10670490/ /pubmed/37998579 http://dx.doi.org/10.3390/diagnostics13223444 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yoo, Ah Young
Joo, Moon Kyung
Park, Jong-Jae
Lee, Beom Jae
Kim, Seung Han
Kim, Won Shik
Chun, Hoon Jai
Recurrent Non-Variceal Upper Gastrointestinal Bleeding among Patients Receiving Dual Antiplatelet Therapy
title Recurrent Non-Variceal Upper Gastrointestinal Bleeding among Patients Receiving Dual Antiplatelet Therapy
title_full Recurrent Non-Variceal Upper Gastrointestinal Bleeding among Patients Receiving Dual Antiplatelet Therapy
title_fullStr Recurrent Non-Variceal Upper Gastrointestinal Bleeding among Patients Receiving Dual Antiplatelet Therapy
title_full_unstemmed Recurrent Non-Variceal Upper Gastrointestinal Bleeding among Patients Receiving Dual Antiplatelet Therapy
title_short Recurrent Non-Variceal Upper Gastrointestinal Bleeding among Patients Receiving Dual Antiplatelet Therapy
title_sort recurrent non-variceal upper gastrointestinal bleeding among patients receiving dual antiplatelet therapy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10670490/
https://www.ncbi.nlm.nih.gov/pubmed/37998579
http://dx.doi.org/10.3390/diagnostics13223444
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