Dr Sauyu Lin and colleagues from North Carolina evaluated predictors for endoscopic therapy in patients who suffer a concomitant upper gastrointestinal bleeding and acute myocardial infarction.
The researchers conducted a retrospective, single center medical record of hospital admissions from 1996 to 2002.
|41% in the upper GI bleeding group had high-risk lesions|
|Digestive Diseases & Sciences|
During the study period, 183 patients underwent an esophagogastroduodenoscopy.
The patients underwent the procedures within 7 days of suffering an acute myocardial infarction and upper gastrointestinal bleeding.
About 41% of patients in the upper gastrointestinal bleeding group had high-risk upper gastrointestinal lesions requiring endoscopic treatment.
The team noted that 17% of patients in the acute myocardial infarction group had high-risk upper gastrointestinal lesions.
Upper gastrointestinal bleeding as the inciting event, patients suffering from hematemesis and hemodynamic instability were associated with requiring endoscopic therapy.
The researchers found that endoscopic findings in the acute myocardial infarction group did alter the decision to perform cardiac catheterization in 43% of patients.
Severe complications occurred in 1% of patients.
Dr Lin's team concludes, “In patients suffering from concomitant upper gastrointestinal bleeding and acute myocardial infarction, urgent endoscopy was most beneficial in patients with upper gastrointestinal bleeding as the initial event and those presenting with hematemesis and hemodynamic instability.”
“In patients without these clinical features, urgent endoscopy may be delayed, unless cardiac management decisions are dependent on endoscopic findings.”