Percutaneous Coronary Intervention in Patients With a History of Gastrointestinal Bleeding (From the Blue Cross Blue Shield of Michigan Cardiovascular Consortium)

Meloche, Chelsea; Seth, Milan; Madder, Ryan D.; Kurlander, Jacob E.; Yaser, Jessica; Chattahi, Joseph; Collins, John; Lingam, Natesh; Arora, Dilip; Gurm, Hitinder S.; Sukul, Devraj

doi:10.1016/j.amjcard.2021.06.013

Cited by 1 publication

(1 citation statement)

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“…In addition to this finding, the current study found that puncture to recanalization time, glucose level on admission, pc-ASPECTS score, general anesthesia, and number of AICA was the related factor for GIH. There was a publication that researched the impact of GIH history on the outcomes after percutaneous coronary intervention in patients with cardiovascular disease and found that GIH history increased the in-hospital bleeding complications (23), which was different from our results. Quick recanalization during EVT can shorten the onset-to-reperfusion time, which could cut down the level of oxygen free radicals in the body and relieve gut inflammatory and immune responses.…”

Section: Discussioncontrasting

confidence: 99%

Effect of Gastrointestinal Hemorrhage on Outcome After Endovascular Treatment in Acute Basilar Artery Occlusion

et al. 2022

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Background and PurposeGastrointestinal hemorrhage (GIH) is associated with a poorer prognosis and a higher mortality rate after acute ischemic stroke (AIS), but its association with outcomes after endovascular treatment (EVT) remains unclear. This study aimed to assess the incidence, risk factors, and relationships among clinical outcomes of GIH after EVT in patients with acute basilar artery occlusion (BAO).MethodsConsecutive patients treated with EVT were identified from the EVT for Acute Basilar Artery Occlusion Study (BASILAR) registry. All enrolled patients were divided into GIH and non-GIH subgroups, and the independent predictors of GIH after EVT were explored. An ordinal logistic regression model was used to assess the association between GIH and primary outcome [distribution of modified Rankin scale (mRS)] at 90 days, while binary logistic regression models for other outcomes were also employed.ResultsAmong 647 patients with acute BAO, 114 (17.6%) patients experienced GIH after EVT. Higher glucose levels at admission, longer procedure time, and general anesthesia were the independent predictors of GIH after EVT, while protective factors include the posterior circulation-Acute Stroke Prognosis Early Computed Tomography Score (pc-ASPECTS) ≥ 5 and a history of hyperlipidemia. Compared with the non-GIH group, the GIH group was associated with a worse functional outcome [adjusted common odds ratio (OR), 2.12 (95% CI, 1.39–3.25)], lower rates of functional independence [adjusted OR,.47 (95% CI, 0.26–0.88)], a favorable outcome [adjusted OR, 0.41 (95% CI, 0.22–0.73)], and a higher risk of 90-day mortality [adjusted OR, 1.76 (95% CI, 1.08–2.85)].ConclusionThis study concluded that GIH is not uncommon after EVT in patients with acute BAO and is associated with worse functional disability and higher mortality.

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Section: Discussioncontrasting

confidence: 99%