Objectives To evaluate the risk and protective factors for UGI bleeding in a large cohort of PCI patients.
Methods A case-control study evaluating UGI bleeding within 7 days following PCI for stable angina and acute coronary syndromes, at Guizhou Provincial Hospital between 2008 and 2011. Cases (n = 27) were identified and outcomes assessed using analysis of data about PCI patients in Discharge Registry Department, and a detailed review of medical notes for each case and four matched controls (n = 108). Analysis of the case and control groups for risk and protective factors was performed using the χ2 test with Fisher's exact P value and logistic regression.
Results The incidence of UGI bleeding following PCI was 1.1% (27 of 2,415 patients). The etiologies of these bleeds were diverse. Risk factors for UGI bleeding were primary PCI (OR49.60, 95%CI 5.799–422.544, P < 0.001), cardiac arrest (OR 3.077, 95% CI 1.122–8.440, P = 0.029), inotropic requirement (OR 13.000, 95% CI 3.616–46.741, P < 0.001), Clopidogrel use before PCI (OR 9.110, 95% CI 1.180–70.250, P = 0.034), and advanced age (OR 18.12, 95% CI 0.985-20.386, P < 0.001). Proton pump inhibitor (PPI) use after PCI (OR0.161, 95% CI 0.052–0.498, P = 0.002) was accompanied by a reduced risk of UGI bleeding.
Conclusions Those undergoing PCI for acute myocardial infarction or in the presence hemodynamic instability are at highest risk, and PPI following PCI may reduce the bleeding risk.