Risk factors of gastrointestinal hemorrhage in patients with coronary heart disease treated with dual antiplatelet therapy
10.3760/cma.j.issn.1008-6706.2019.11.010
- VernacularTitle: 冠心病双联抗血小板治疗中消化道出血的相关危险因素分析
- Author:
Erdong GENG
1
;
Juan NING
2
Author Information
1. Department of Emergency, International Hospital of Peking University, Beijing 102206, China
2. Department of Oncology, Beijing Chaoyang Hospital Huairou Hospital of Capital Medical University, Beijing 101400, China
- Publication Type:Journal Article
- Keywords:
Coronary artery disease;
Platelet aggregation inhibitors;
Aspirin;
Clopidogrel;
Drug therapy, combination;
Gastrointestinal hemorrhage;
Risk factors;
Factor analysis, statistical
- From:
Chinese Journal of Primary Medicine and Pharmacy
2019;26(11):1321-1324
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the risk factors of gastrointestinal hemorrhage in coronary heart disease(CHD) patients treated by dual anti-platelet therapy.
Methods:From January 2015 to January 2017, 200 patients with CHD in International Hospital of Peking University were studied and randomly divided into two groups according to the digital table, with 100 cases in each group.The treatment group was treated with aspirin and clopidogrel, and the control group was treated with aspirin.The patients were treated for 12 months and followed up for 6 months.The incidence rate of gastrointestinal hemorrhage was observed in the two groups, and the sex, age, renal function, HP infection, high risk of global registration of acute coronary events (GRACE) score and time of medication, combined with oral proton pump inhibitor(PPI), gastrointestinal history and other data were analyzed in the patients with gastrointestinal bleeding in the course of dual antiplatelet therapy.The risk factors of gastrointestinal hemorrhage in CHD patients treated with dual anti-platelet therapy were analyzed.
Results:The incidence rate of gastrointestinal bleeding of the treatment group[39.0%(39/100)] was higher than that of the control group[1.0%(1/100)](χ2=12.365, P<0.01). The age(over 70 years old)(30.0%), renal function(29.0%), Hp infection(29.0%), load dose(28.0%), combined oral PPI(26.0%) and gastrointestinal history(31.0%) in the patients with hemorrhage were significantly higher than those in the patients without bleeding(χ2=6.326, 6.326, 5.689, 6.124, 6.054, 5.365, 6.985, all P<0.05). There were no statistically significant differences in sex and GRACE score between the hemorrhage patients and patients without bleeding (all P>0.05). Multivariate logistic regression analysis showed that age, renal dysfunction and HP infection, load dose, medication time more than 3 months, combined oral administration of PPI, gastrointestinal history were the risk factors of gastrointestinal bleeding in patients with CHD combined with anti-platelet therapy(r=9.646, 7.435, 6.435, 11.769, 3.052, 4.199, 8.511, all P<0.05).
Conclusion:The patients with CHD are prone to gastrointestinal bleeding after dual antiplatelet therapy, and they are over 70 years old and suffer from renal insufficiency.The risk of gastrointestinal bleeding can be increased by loading dose of HP infection.
