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Gastrointestinal bleeding increases the risk of subsequent cardiovascular events in patients with acute cardiovascular diseases requiring intensive care

Gastrointestinal (GI) bleeding worsens the outcomes of critically ill patients in the intensive care unit (ICU). Owing to a lack of corresponding data, we aimed to investigate whether GI bleeding during cardiovascular-ICU (C-ICU) admission in acute cardiovascular (CV) disease patients is a risk fact...

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Autores principales: Sakai, Shin, Tara, Shuhei, Yamamoto, Takeshi, Asano, Kazuhiro, Kimura, Tokuhiro, Fujimoto, Yuhi, Shiomura, Reiko, Matsuda, Junya, Kadooka, Kosuke, Takahashi, Kenta, Ko, Toshinori, Sangen, Hideto, Saiki, Yoshiyuki, Nakata, Jun, Hosokawa, Yusuke, Takano, Hitoshi, Shimizu, Wataru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Japan 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937548/
https://www.ncbi.nlm.nih.gov/pubmed/33683409
http://dx.doi.org/10.1007/s00380-021-01822-1
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author Sakai, Shin
Tara, Shuhei
Yamamoto, Takeshi
Asano, Kazuhiro
Kimura, Tokuhiro
Fujimoto, Yuhi
Shiomura, Reiko
Matsuda, Junya
Kadooka, Kosuke
Takahashi, Kenta
Ko, Toshinori
Sangen, Hideto
Saiki, Yoshiyuki
Nakata, Jun
Hosokawa, Yusuke
Takano, Hitoshi
Shimizu, Wataru
author_facet Sakai, Shin
Tara, Shuhei
Yamamoto, Takeshi
Asano, Kazuhiro
Kimura, Tokuhiro
Fujimoto, Yuhi
Shiomura, Reiko
Matsuda, Junya
Kadooka, Kosuke
Takahashi, Kenta
Ko, Toshinori
Sangen, Hideto
Saiki, Yoshiyuki
Nakata, Jun
Hosokawa, Yusuke
Takano, Hitoshi
Shimizu, Wataru
author_sort Sakai, Shin
collection PubMed
description Gastrointestinal (GI) bleeding worsens the outcomes of critically ill patients in the intensive care unit (ICU). Owing to a lack of corresponding data, we aimed to investigate whether GI bleeding during cardiovascular-ICU (C-ICU) admission in acute cardiovascular (CV) disease patients is a risk factor for subsequent CV events. Totally, 492 consecutive C-ICU patients (40.9% acute coronary syndrome, 22.8% heart failure) were grouped into GI bleeding (n = 27; 12 upper GI and 15 lower GI) and non-GI bleeding (n = 465) groups. Thirty-nine patients died or developed CV events during hospitalization, and 453 were followed up from the date of C-ICU discharge to evaluate subsequent major adverse CV events. The GI bleeding group had a higher Acute Physiology and Chronic Health Evaluation II score (20.2 ± 8.2 vs. 15.1 ± 6.8, p < 0.001), higher frequency of mechanical ventilator use (29.6% vs. 13.1%, p = 0.039), and longer C-ICU admission duration (8 [5–16] days vs. 5 [3–8] days, p < 0.001) than the non-GI bleeding group. The in-hospital mortality rate did not differ between the groups. Of those who were followed-up, CV events after C-ICU discharge were identified in 34.6% and 14.3% of patients in the GI and non-GI bleeding groups, respectively, during a median follow-up period of 228 days (log rank, p < 0.001). GI bleeding was an independent risk factor for subsequent CV events (adjusted hazard ratio: 2.23, 95% confidence interval: 1.06–4.71; p = 0.035). GI bleeding during C-ICU admission was independently associated with subsequent CV events in such settings.
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spelling pubmed-79375482021-03-08 Gastrointestinal bleeding increases the risk of subsequent cardiovascular events in patients with acute cardiovascular diseases requiring intensive care Sakai, Shin Tara, Shuhei Yamamoto, Takeshi Asano, Kazuhiro Kimura, Tokuhiro Fujimoto, Yuhi Shiomura, Reiko Matsuda, Junya Kadooka, Kosuke Takahashi, Kenta Ko, Toshinori Sangen, Hideto Saiki, Yoshiyuki Nakata, Jun Hosokawa, Yusuke Takano, Hitoshi Shimizu, Wataru Heart Vessels Original Article Gastrointestinal (GI) bleeding worsens the outcomes of critically ill patients in the intensive care unit (ICU). Owing to a lack of corresponding data, we aimed to investigate whether GI bleeding during cardiovascular-ICU (C-ICU) admission in acute cardiovascular (CV) disease patients is a risk factor for subsequent CV events. Totally, 492 consecutive C-ICU patients (40.9% acute coronary syndrome, 22.8% heart failure) were grouped into GI bleeding (n = 27; 12 upper GI and 15 lower GI) and non-GI bleeding (n = 465) groups. Thirty-nine patients died or developed CV events during hospitalization, and 453 were followed up from the date of C-ICU discharge to evaluate subsequent major adverse CV events. The GI bleeding group had a higher Acute Physiology and Chronic Health Evaluation II score (20.2 ± 8.2 vs. 15.1 ± 6.8, p < 0.001), higher frequency of mechanical ventilator use (29.6% vs. 13.1%, p = 0.039), and longer C-ICU admission duration (8 [5–16] days vs. 5 [3–8] days, p < 0.001) than the non-GI bleeding group. The in-hospital mortality rate did not differ between the groups. Of those who were followed-up, CV events after C-ICU discharge were identified in 34.6% and 14.3% of patients in the GI and non-GI bleeding groups, respectively, during a median follow-up period of 228 days (log rank, p < 0.001). GI bleeding was an independent risk factor for subsequent CV events (adjusted hazard ratio: 2.23, 95% confidence interval: 1.06–4.71; p = 0.035). GI bleeding during C-ICU admission was independently associated with subsequent CV events in such settings. Springer Japan 2021-03-08 2021 /pmc/articles/PMC7937548/ /pubmed/33683409 http://dx.doi.org/10.1007/s00380-021-01822-1 Text en © Springer Japan KK, part of Springer Nature 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Article
Sakai, Shin
Tara, Shuhei
Yamamoto, Takeshi
Asano, Kazuhiro
Kimura, Tokuhiro
Fujimoto, Yuhi
Shiomura, Reiko
Matsuda, Junya
Kadooka, Kosuke
Takahashi, Kenta
Ko, Toshinori
Sangen, Hideto
Saiki, Yoshiyuki
Nakata, Jun
Hosokawa, Yusuke
Takano, Hitoshi
Shimizu, Wataru
Gastrointestinal bleeding increases the risk of subsequent cardiovascular events in patients with acute cardiovascular diseases requiring intensive care
title Gastrointestinal bleeding increases the risk of subsequent cardiovascular events in patients with acute cardiovascular diseases requiring intensive care
title_full Gastrointestinal bleeding increases the risk of subsequent cardiovascular events in patients with acute cardiovascular diseases requiring intensive care
title_fullStr Gastrointestinal bleeding increases the risk of subsequent cardiovascular events in patients with acute cardiovascular diseases requiring intensive care
title_full_unstemmed Gastrointestinal bleeding increases the risk of subsequent cardiovascular events in patients with acute cardiovascular diseases requiring intensive care
title_short Gastrointestinal bleeding increases the risk of subsequent cardiovascular events in patients with acute cardiovascular diseases requiring intensive care
title_sort gastrointestinal bleeding increases the risk of subsequent cardiovascular events in patients with acute cardiovascular diseases requiring intensive care
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937548/
https://www.ncbi.nlm.nih.gov/pubmed/33683409
http://dx.doi.org/10.1007/s00380-021-01822-1
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