TITLE:
Risk Factors for Gastrointestinal Injuries in Acute Coronary Syndrome Patients with Double Antiplatelet Therapy in One-Year Follow-Up
AUTHORS:
Ling Zhong, Xin Chen, Xihua Qiu, Xueli Zhang, Hua Shao, Yamin Liu, Jing Xiong
KEYWORDS:
Acute Coronary Syndrome, Double Antiplatelet Therapy, Proton Pump Inhibitor, Serious Gastrointestinal Complications, Symptomatic Gastrointestinal Injury, Risk Factors
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.8 No.10,
October
15,
2018
ABSTRACT: Background: The goal is to determine the incidence of symptomatic gastrointestinal (GI) injuries in acute coronary syndrome (ACS) patients receiving double antiplatelet therapy (DAPT). The risk factors for serious GI complications are also evaluated. Methods: 603 eligible patients from the Department of Cardiology at Zhongda Hospital between January 2014 and August 2015 were enrolled and the occurrence of GI injuries within one year assessed. The risk factors for serious GI complications were identified using cox regression analysis. Results: After one-year follow-up, 108 (17.9%) out of 603 patients developed symptomatic GI injuries: 22 (3.65%) with serious GI complications and 86 (14.2%) with GI symptoms. Drinking habit (95% CI: 1.512 - 8.796; P = 0.004) and previous peptic injury (95% CI: 2.307 - 18.080; P = 0.001) are independent predictors of serious GI complications, while proton pump inhibitor (PPI) was protective (95% CI: 0.120 - 0.699; P = 0.006) per cox regression analysis. Additionally, GI injuries of both serious GI complications and GI symptoms peaked in the first three months. Conclusions: Symptomatic GI injuries were relatively common in ACS patients with DAPT, especially in the first three months. Previous peptic injury and drinking habit were significant independent risk factors for serious GI complications, while PPI played a protective role in ACS with DAPT.