Clinical review: gastrointestinal bleeding after percutaneous coronary intervention: a deadly combination

QJM : Monthly Journal of the Association of Physicians
P FoleyR A Anderson

Abstract

Managing gastrointestinal bleeding in a patient who has undergone recent percutaneous coronary intervention requires balancing the risk of stent thrombosis against further catastrophic bleeding. Stent thrombosis and severe gastrointestinal bleeding are life-threatening complications. To evaluate the risks of gastrointestinal bleeding in patients undergoing percutaneous coronary intervention in relation to anti-platelet therapy and to discuss management of gastrointestinal bleeding in these patients. Review of published studies comparing anti-platelet and ulcer healing therapy. A review of the evidence surrounding the management of gastrointestinal bleeding and the need for anti-platelet therapy in patients undergoing percutaneous coronary intervention. Gastrointestinal bleeding is relatively common after percutaneous coronary intervention. In one study it complicated 2.3% of primary angioplasty, and these patients had a mortality of 10%. Recent registry data of patients experiencing a gastrointestinal bleed reported a mortality of 5.4%. Cessation of anti-platelet therapy carries a high risk of acute stent thrombosis, which has a high mortality. Individualized specialist gastrointestinal and cardiological management of these pat...Continue Reading

Citations

Sep 14, 2011·Nature Reviews. Cardiology·Arun KalyanasundaramUNKNOWN Medscape
Aug 13, 2010·Medicina clínica·Alvaro MerinoUNKNOWN Grupo de Trabajo de Trombosis Cardiovascular de la Sociedad Española de Cardiología (addendum)
Aug 27, 2009·The American Journal of Cardiology·Eugenia NikolskyGregg W Stone
Jul 5, 2015·Gastrointestinal Endoscopy Clinics of North America·Thomas TiellemanByron Cryer
May 5, 2016·Current Medical Research and Opinion·Phillip FreemanRichard Anderson
Jul 31, 2008·QJM : Monthly Journal of the Association of Physicians·Sergio Manzano-FernándezGregory Y H Lip

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