Predictive and Protective Factors Associated With Upper Gastrointestinal Bleeding After Percutaneous Coronary Intervention: A Case-Control Study

Objective: To assess the association between PTGS1 and NOS3 variant alleles and the risk to develop upper gastrointestinal bleeding (UGIB) secondary to complicated peptic disease.Methods: A case–control study was conducted in a Brazilian complex hospital from July 2016 to March 2020. Case: Patients with UGIB diagnosis. Control: Patients admitted for surgery not related to gastrointestinal disorders. Variables: UGIB (outcome), genetic variants in PTGS1 and NOS3 genes (independent), and sex, age, schooling, ethnicity, previous history of gastrointestinal disorders, Helicobacter pylori serology, comorbidity, drug therapy, and lifestyle (confounding). The single-nucleotide polymorphisms (SNPs) of the PTSG1 gene (rs1330344, rs3842787, rs10306114, and rs5788) and NOS3 gene (rs2070744 and rs1799983) were determined using the real-time polymerase chain reaction. Helicobacter pylori serology was determined through the chemiluminescence technique. Logistic regression models were built and deviations of allelic frequencies from Hardy–Weinberg equilibrium were verified.Results: 200 cases and 706 controls were recruited. Carriers of the AG genotype of rs10306114 (OR: 2.55, CI 95%: 1.13–5.76) and CA + AA genotypes of rs5788 (OR: 2.53, CI 95%: 1.14–5.59) were associated with an increased risk for the UGIB development. In nonsteroidal anti-inflammatory drugs (NSAIDs) users, the six variants evaluated modified the magnitude of the risk of UGIB, whereas in low-dose aspirin (LDA) users, an increased risk of UGIB was observed for four of them (rs1330344, rs10306114, rs2070744, and rs1799983). Personal ulcer history (p-value: < 0.001); Helicobacter pylori infection (p-value: < 0.011); NSAIDs, LDA, and oral anticoagulant use (p-value: < 0.001); and alcohol intake (p-value: < 0.001) were also identified as independent risk factors for UGIB.Conclusion: This study presents two unprecedented analyses within the scope of the UGIB (rs10306114 and rs2070744), and our findings showing an increased risk of UGIB in the presence of the genetic variants rs10306114 and rs5788, regardless of the drug exposure. Besides, the presence of the evaluated variants might modify the magnitude of the risk of UGIB in LDA/NSAIDs users. Therefore, our data suggest the need for a personalized therapy and drug use monitoring in order to promote patient safety.

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Case-control study on the association of upper gastrointestinal bleeding and nonsteroidal anti-inflammatory drugs in Japan

European Journal of Clinical Pharmacology ◽

10.1007/s00228-006-0171-6 ◽

2006 ◽

Vol 62 (9) ◽

pp. 765-772 ◽

Cited By ~ 96

Author(s):

Choitsu Sakamoto ◽

Kentaro Sugano ◽

Shinichi Ota ◽

Nobuhiro Sakaki ◽

Shin’ichi Takahashi ◽

...

Keyword(s):

Gastrointestinal Bleeding ◽

Case Control Study ◽

Upper Gastrointestinal Bleeding ◽

Case Control ◽

Inflammatory Drugs ◽

Anti Inflammatory ◽

Upper Gastrointestinal ◽

Control Study

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UPPER GASTROINTESTINAL BLEEDING IS ASSOCIATED WITH SIGNIFICANT MORTALITY IN PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION FOR STABLE ISCHEMIC HEART DISEASE

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(19)30862-9 ◽

2019 ◽

Vol 73 (9) ◽

pp. 254

Author(s):

Fawad Virk ◽

Muhammad Choudhry ◽

Hussain Ibrahim ◽

Wissam Khalife ◽

Umamahesh Rangasetty ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Heart Disease ◽

Gastrointestinal Bleeding ◽

Ischemic Heart Disease ◽

Upper Gastrointestinal Bleeding ◽

Coronary Intervention ◽

Ischemic Heart ◽

Percutaneous Coronary ◽

Upper Gastrointestinal ◽

Significant Mortality

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Associations of myeloperoxidase, interleukin-17A and heparin-binding EGF-like growth factor levels with in-stent restenosis after percutaneous coronary intervention: a single-centre case–control study in China

BMJ Open ◽

10.1136/bmjopen-2020-039405 ◽

2020 ◽

Vol 10 (11) ◽

pp. e039405

Author(s):

Hua Jiang ◽

Hongmei Zhang ◽

Ying Yang ◽

Xuezhou Yang

Keyword(s):

Percutaneous Coronary Intervention ◽

Growth Factor ◽

Case Control Study ◽

Coronary Intervention ◽

Case Control ◽

Heparin Binding ◽

Stent Restenosis ◽

Percutaneous Coronary ◽

Control Study ◽

In Stent Restenosis

ObjectivesTo investigate the changes in serum myeloperoxidase (MPO), interleukin (IL)-17A and heparin-binding EGF-like growth factor (HB-EGF) levels before and after percutaneous coronary intervention (PCI), and to evaluate the associations of MPO, IL-17A and HB-EGF levels with the 1-year restenosis rate.DesignCase–control study.SettingsXiangyang Central Hospital between January 2012 and December 2017.ParticipantsPatients with coronary heart disease who underwent PCI.InterventionsNot applicable.Primary and secondary outcome measuresNot applicable.ResultsFinally, 407 and 132 patients were included in the control and in-stent restenosis (ISR) groups, respectively. The general clinical characteristics of the patients were not significantly different between the two groups. The MPO, IL-17A and HB-EGF levels were not significantly different between the two groups at baseline but significantly increased after PCI. The ISR group showed higher levels of MPO, IL-17A and HB-EGF compared with the control group at all postoperative time points. Multivariable analysis showed that MPO, IL-17A and HB-EGF were associated with increased ISR [MPO (OR=1.003; 95% CI: 1.001 to 1.005; p=0.002), IL-17A (OR=1.015; 95% CI: 1.009 to 1.020; p<0.0001) and HB-EGF (OR=2.256; 95% CI: 1.103 to 4.009; p=0.002)]. All three factors had sensitivity and specificity ≥68% for ISR.ConclusionsHB-EGF could be used for the detection of ISR after PCI and could be of use for the prediction of ISR, but the value of MPO and IL-17A might be more limited. This will have to be validated in future studies.

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Cardiovascular and renal outcomes following percutaneous coronary intervention in a population with renal disease: a case-control study

QJM ◽

10.1093/qjmed/hcz130 ◽

2019 ◽

Vol 112 (9) ◽

pp. 669-674

Author(s):

L A Allen ◽

R D Pyart ◽

J Holmes ◽

K L Donovan ◽

R A Anderson ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Calcium Phosphate ◽

Serum Creatinine ◽

Case Control Study ◽

Coronary Intervention ◽

Case Control ◽

Percutaneous Coronary ◽

Phosphate Product ◽

Poor Outcomes ◽

Control Study

Abstract Background Patients with renal disease are less likely to undergo percutaneous coronary intervention (PCI) due to concerns about poor outcomes. Aim We describe outcomes following PCI in individuals with chronic kidney disease (CKD), as compared with matched controls with comparable CKD who did not undergo PCI. We also identified factors predictive of poor outcomes following PCI amongst patients with CKD. Design Retrospective observational case-control study. Methods Cases were individuals with CKD (stages 1–5) undergoing PCI between 2008 and 2014. Controls were age, gender and creatinine-matched individuals not requiring PCI. We compared mortality between groups using Kaplan–Meier curves and Cox regression modelling. We assessed changes in serum creatinine using Wilcoxon Rank testing. We explored the relationship between biochemical and haematological measures (baseline creatinine, calcium, phosphate, calcium-phosphate product, parathyroid hormone, white cell count, haemoglobin, platelet count, c-reactive protein and total cholesterol) and post-PCI mortality, using logistic regression. Results We identified 144 cases and 144 controls. Mortality was significantly lower amongst cases compared with controls [hazard ratio 0.46 (95% confidence intervals 0.31, 0.69)]. PCI did not result in a significant change in renal function (P=0.52). Amongst cases, serum creatinine and calcium-phosphate product were predictors of mortality following PCI. Conclusion Cases undergoing PCI had lower mortality, and PCI was not associated with accelerated CKD progression. On this data, PCI should not be deferred as a treatment option in patients with CKD. Serum creatinine and calcium-phosphate product predict mortality following PCI in this cohort, and may be useful in risk-stratifying patients with CKD being considered for PCI.

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