Major Adverse Upper Gastrointestinal Events in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Coronary Intervention and Dual Antiplatelet Therapy

作者：Chen Yung Lung; Chang Chia Lo; Chen Huang Chung; Sun Cheuk Kwan; Yeh Kuo Ho; Tsai Tzu Hsien; Chen Chien Jen; Chen Shyh Ming; Yang Cheng Hsu; Hang Chi Ling; Wu Chiung Jen; Yip Hon Kan^*

来源：American Journal of Cardiology, 2011, 108(12): 1704-1709.

DOI：10.1016/j.amjcard.2011.07.039

The aim of this study was to investigate the incidence of composite short-term and long-term major adverse upper gastrointestinal (UGI) events (MAUGIEs; defined as gastric ulcer, duodenal ulcer, gastroduodenal ulcer, or UGI bleeding) in patients with acute ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention and routinely received dual-antiplatelet therapy. From May 2002 to September 2010, a total of 1,368 consecutive patients who experienced ST-segment elevation myocardial infarction and underwent primary percutaneous coronary intervention were prospectively enrolled in the study. The incidence of in-hospital UGI bleeding complications and composite MAUGIEs was 8.9% and 9.9%, respectively. The in-hospital mortality rate was significantly higher in patients with in-hospital MAUGIEs than in those without (p < 0.001). Multivariate analysis showed that age, advanced Killip score (>= 3), and respiratory failure were the strongest independent predictors of in-hospital composite MAUGIEs (all p < 0.003). The cumulative composite of MAUGIEs after uneventful discharge in patients without adverse UGI events who continuously received dual-antiplatelet therapy for 3 to 12 months, followed by aspirin therapy, was 10.4% during long-term (mean 4.0 years) follow-up. In conclusion, the results of this study show a remarkably high incidence of composite short-term and long-term MAUGIEs in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention and received routine dual-antiplatelet therapy. Age, advanced Killip score, and respiratory failure were significantly and independently predictive of in-hospital composite MAUGIEs.

• 出版日期2011-12-15
• 单位长春大学