Clinical Characteristics and Risk Factors of In-Hospital Mortality in Patients With Acute Myocardial Infarction With Subsequent Gastrointestinal Bleeding: A Single-Center Experience
ObjectiveGastrointestinal bleeding (GIB) post acute myocardial infarction (AMI) is a severe clinical condition with a poor prognosis. The purpose of the study was to evaluate the rate of in-hospital mortality in patients with GIB post-AMI and to identify the potential risk factors of this situation....
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.942467/full |
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| author | Xin Su Yuzhen Wei Shuo Pang Zeqing Zhang Yunxiao Zhang Peipei Zheng Haiyu Li Haiqiang Sang Jianzeng Dong Jianzeng Dong |
| author_facet | Xin Su Yuzhen Wei Shuo Pang Zeqing Zhang Yunxiao Zhang Peipei Zheng Haiyu Li Haiqiang Sang Jianzeng Dong Jianzeng Dong |
| author_sort | Xin Su |
| collection | DOAJ |
| description | ObjectiveGastrointestinal bleeding (GIB) post acute myocardial infarction (AMI) is a severe clinical condition with a poor prognosis. The purpose of the study was to evaluate the rate of in-hospital mortality in patients with GIB post-AMI and to identify the potential risk factors of this situation.MethodsIn this single-center retrospective study, a total of 154 patients diagnosed with AMI who subsequently suffered GIB were enrolled from October 2013 to December 2021. Demographic, laboratory, and clinical data were collected. The in-hospital mortality was the outcome of interest. Logistic regression analysis was used to investigate the potential risk factors of in-hospital mortality.ResultsAmong the 154 subjects included in the final analysis, the mean age was 65.58 ± 11.20 years, and 104 (67.53%) were males. GIB occurred in 11 patients after thrombolytic therapy, 50 patients after percutaneous coronary intervention (PCI), and 93 patients during drug conservative treatment. A total of 41 patients died in the hospital. The in-hospital mortality rate of the thrombolysis group, PCI group, and drug conservative treatment group was 27.27% (3/11), 28.00% (14/50), and 25.81% (24/93), respectively. There was no difference in the in-hospital mortality among the three groups. The multivariate logistic regression analysis showed that the peak levels of TnI (OR 1.07, 95% CI 1.02–1.12, P = 0.011), condition of cardiogenic shock after admission (OR 14.52, 95% CI 3.36–62.62, P < 0.001), and the use of the mechanical ventilator (OR 8.14, 95% CI 2.03–32.59, P = 0.003) were significantly associated with in-hospital mortality.ConclusionRegardless of the treatment strategy for AMI, once GIB occurred, the prognosis was poor. High in-hospital mortality in patients with GIB post-AMI was independently associated with the peak levels of TnI, condition of cardiogenic shock, and the use of a mechanical ventilator. |
| first_indexed | 2024-04-13T04:44:01Z |
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| id | doaj.art-242a75a9e0c44c27bd29177396b8a1c4 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-13T04:44:01Z |
| publishDate | 2022-07-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-242a75a9e0c44c27bd29177396b8a1c42022-12-22T03:01:53ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-07-01910.3389/fcvm.2022.942467942467Clinical Characteristics and Risk Factors of In-Hospital Mortality in Patients With Acute Myocardial Infarction With Subsequent Gastrointestinal Bleeding: A Single-Center ExperienceXin Su0Yuzhen Wei1Shuo Pang2Zeqing Zhang3Yunxiao Zhang4Peipei Zheng5Haiyu Li6Haiqiang Sang7Jianzeng Dong8Jianzeng Dong9Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaObjectiveGastrointestinal bleeding (GIB) post acute myocardial infarction (AMI) is a severe clinical condition with a poor prognosis. The purpose of the study was to evaluate the rate of in-hospital mortality in patients with GIB post-AMI and to identify the potential risk factors of this situation.MethodsIn this single-center retrospective study, a total of 154 patients diagnosed with AMI who subsequently suffered GIB were enrolled from October 2013 to December 2021. Demographic, laboratory, and clinical data were collected. The in-hospital mortality was the outcome of interest. Logistic regression analysis was used to investigate the potential risk factors of in-hospital mortality.ResultsAmong the 154 subjects included in the final analysis, the mean age was 65.58 ± 11.20 years, and 104 (67.53%) were males. GIB occurred in 11 patients after thrombolytic therapy, 50 patients after percutaneous coronary intervention (PCI), and 93 patients during drug conservative treatment. A total of 41 patients died in the hospital. The in-hospital mortality rate of the thrombolysis group, PCI group, and drug conservative treatment group was 27.27% (3/11), 28.00% (14/50), and 25.81% (24/93), respectively. There was no difference in the in-hospital mortality among the three groups. The multivariate logistic regression analysis showed that the peak levels of TnI (OR 1.07, 95% CI 1.02–1.12, P = 0.011), condition of cardiogenic shock after admission (OR 14.52, 95% CI 3.36–62.62, P < 0.001), and the use of the mechanical ventilator (OR 8.14, 95% CI 2.03–32.59, P = 0.003) were significantly associated with in-hospital mortality.ConclusionRegardless of the treatment strategy for AMI, once GIB occurred, the prognosis was poor. High in-hospital mortality in patients with GIB post-AMI was independently associated with the peak levels of TnI, condition of cardiogenic shock, and the use of a mechanical ventilator.https://www.frontiersin.org/articles/10.3389/fcvm.2022.942467/fullacute myocardial infarctiongastrointestinal bleedingin-hospital mortalitythrombolysispercutaneous coronary intervention |
| spellingShingle | Xin Su Yuzhen Wei Shuo Pang Zeqing Zhang Yunxiao Zhang Peipei Zheng Haiyu Li Haiqiang Sang Jianzeng Dong Jianzeng Dong Clinical Characteristics and Risk Factors of In-Hospital Mortality in Patients With Acute Myocardial Infarction With Subsequent Gastrointestinal Bleeding: A Single-Center Experience Frontiers in Cardiovascular Medicine acute myocardial infarction gastrointestinal bleeding in-hospital mortality thrombolysis percutaneous coronary intervention |
| title | Clinical Characteristics and Risk Factors of In-Hospital Mortality in Patients With Acute Myocardial Infarction With Subsequent Gastrointestinal Bleeding: A Single-Center Experience |
| title_full | Clinical Characteristics and Risk Factors of In-Hospital Mortality in Patients With Acute Myocardial Infarction With Subsequent Gastrointestinal Bleeding: A Single-Center Experience |
| title_fullStr | Clinical Characteristics and Risk Factors of In-Hospital Mortality in Patients With Acute Myocardial Infarction With Subsequent Gastrointestinal Bleeding: A Single-Center Experience |
| title_full_unstemmed | Clinical Characteristics and Risk Factors of In-Hospital Mortality in Patients With Acute Myocardial Infarction With Subsequent Gastrointestinal Bleeding: A Single-Center Experience |
| title_short | Clinical Characteristics and Risk Factors of In-Hospital Mortality in Patients With Acute Myocardial Infarction With Subsequent Gastrointestinal Bleeding: A Single-Center Experience |
| title_sort | clinical characteristics and risk factors of in hospital mortality in patients with acute myocardial infarction with subsequent gastrointestinal bleeding a single center experience |
| topic | acute myocardial infarction gastrointestinal bleeding in-hospital mortality thrombolysis percutaneous coronary intervention |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.942467/full |
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