PMID- 20377468
OWN - NLM
STAT- MEDLINE
DCOM- 20110103
LR  - 20100811
IS  - 1502-7708 (Electronic)
IS  - 0036-5521 (Linking)
VI  - 45
IP  - 9
DP  - 2010 Sep
TI  - Investigation of upper gastrointestinal bleeding after implantation of 
      drug-eluting stents; prospective cohort study.
PG  - 1097-100
LID - 10.3109/00365521003797197 [doi]
AB  - OBJECTIVE: After implantation of drug-eluting stents (DES), two or more 
      anti-thrombotic agents are required. The risk of upper gastrointestinal bleeding 
      (UGIB) in cases of DES implantation is thought to be significant. However, the 
      incidence of UGIB has not yet been investigated in DES-implanted patients. This 
      study aimed to investigate the incidence of UGIB after DES implantation and the 
      awareness among cardiologists about this complication. MATERIAL AND METHODS: 
      Subjects were 397 consecutive patients implanted with DES from August 2004 to 
      September 2007 at two institutions. Endoscopic examinations were performed on 
      DES-implanted patients who presented with hematemesis and/or tarry stools. The 
      concomitant use of acid-suppressing agents was left to the cardiologists. In 
      addition, 37 cardiologists were administered a questionnaire regarding UGIB after 
      DES implantation. RESULTS: Low-dose aspirin and ticlopidine were prescribed in 
      all patients. Forty-six patients had a past history of peptic ulcer. 
      Acid-suppressing agents were concomitantly prescribed to 224 patients (56%) 
      including 32 patients (70%) with a past history of peptic ulcer. UGIB due to 
      gastric ulcers developed in 5 cases (1.3%). One case had received a half dose of 
      H2-RA. No bleeding occurred in patients who received proton pump inhibitors 
      (PPI). The incidence of UGIB was 4.0 per 1000 patient-years. The cardiologists 
      who were surveyed recognized the risk of UGIB after DES implantation and the 
      necessity for its prevention. However, they indicated that adequate management 
      for preventing this complication has not been established. CONCLUSIONS: This 
      study reassuringly demonstrated a low incidence of UGIB after DES implantation. 
      Further study regarding the prophylaxis for UGIB after DES implantation is 
      necessary.
FAU - Toyokawa, Tatsuya
AU  - Toyokawa T
AD  - Department of Gastroenterology, National Hospital Organization, Fukuyama Medical 
      Center, Fukuyama, Hiroshima, Japan. toyotatu@kmail.plala.or.jp
FAU - Inaba, Tomoki
AU  - Inaba T
FAU - Ishikawa, Shigenao
AU  - Ishikawa S
FAU - Nakatsu, Morihito
AU  - Nakatsu M
FAU - Ando, Masaharu
AU  - Ando M
FAU - Tomoda, Jun
AU  - Tomoda J
LA  - eng
PT  - Journal Article
PL  - England
TA  - Scand J Gastroenterol
JT  - Scandinavian journal of gastroenterology
JID - 0060105
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cohort Studies
MH  - Drug-Eluting Stents/*adverse effects
MH  - Female
MH  - Fibrinolytic Agents/*adverse effects
MH  - Gastrointestinal Hemorrhage/*chemically induced/*epidemiology
MH  - Hematemesis/chemically induced/epidemiology
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Melena/chemically induced/epidemiology
MH  - Middle Aged
MH  - Prospective Studies
MH  - Treatment Outcome
EDAT- 2010/04/10 06:00
MHDA- 2011/01/05 06:00
CRDT- 2010/04/10 06:00
PHST- 2010/04/10 06:00 [entrez]
PHST- 2010/04/10 06:00 [pubmed]
PHST- 2011/01/05 06:00 [medline]
AID - 10.3109/00365521003797197 [doi]
PST - ppublish
SO  - Scand J Gastroenterol. 2010 Sep;45(9):1097-100. doi: 10.3109/00365521003797197.