Impact of Prior Digestive System Disease on In-Hospital Gastrointestinal Bleeding in Patients with Acute Myocardial Infarction

Yu Liu,1 Le-Feng Wang,1 Li-Hong Liu,1 Xin-Chun Yang,1 Zheng-Hong Ren,2 Kui-Bao Li,1 Mu-Lei Chen,1 Hong-Shi Wang,1 Jiu-Chang Zhong,1 Li Xu,1 Zhu-Hua Ni,1 Wei-Ming Li,1 Kun Xia,1 Da-Peng Zhang,1 Hao Sun,1 Zong-Sheng Guo,1 Yong-Hui Chi,1 Ji-Fang He,1 Zhi-Yong Zhang,1 Feng Jiang1 1Heart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China; 2School of Public Health, Peking University Health Science Center, Beijing, People’s Republic of ChinaCorrespondence: Le-Feng WangHeart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, No. 8 of Gongtinan Road, Chaoyang District, Beijing, People’s Republic of ChinaTel/Fax +86 10 85231173Email wanglefeng_dr66@163.comObjective: Patients presenting with acute myocardial infarction (AMI) with prior digestive system disease are more likely to suffer from gastrointestinal (GI) bleeding than those without these diseases. However, few articles reported how the different conditions of the digestive tract produced different risks of GI bleeding.Methods: A single-center study on 7464 patients admitted for AMI from December 2010 to June 2019 in the Beijing Chaoyang Heart Center was retrospectively examined. Patients with major GI bleeding (n = 165) were compared with patients without (n = 7299). Univariate and multivariate logistic regression models were constructed to test the association between GI bleeding and prior diseases of the digestive tract, including gastroesophageal reflux disease, chronic gastritis, peptic ulcer, hepatic function damage, diseases of the colon and rectum, and gastroenterological tract tumors.Results: Of the 7464 patients (mean age, 63.4; women, 25.6%; STEMI, 58.6%), 165 (2.2%) experienced major GI bleeding, and 1816 (24.3%) had a history of digestive system disease. The risk of GI bleeding was significantly associated with peptic ulcer (OR = 4.19, 95% CI: 1.86– 9.45) and gastroenterological tumor (OR = 2.74, 95% CI: 1.07– 7.04), indicated by multivariate logistic regression analysis.Conclusion: Preexisting peptic ulcers and gastroenterological tract tumors rather than other digestive system diseases were indicators of gastrointestinal bleeding in patients with AMI who undergo standard antithrombotic treatment during hospitalization.Keywords: gastrointestinal bleeding, digestive system disease, acute myocardial infarction, peptic ulcer, gastroenterological tract tumor