Non-variceal gastrointestinal bleeding in patients with cardiovascular diseases
https://doi.org/10.31146/1682-8658-ecg-228-8-28-36
Abstract
Objective: To study the condition of the upper gastrointestinal mucosa, frequency of gastrointestinal bleeding, risk factors according to the “REGATA” scale (2021), and assess the effectiveness of endoscopic hemostasis methods in patients with atherosclerosis. Materials and Methods: We studied 118 patients (main group - MG) with atherosclerosis of the visceral branches of the abdominal aorta and 120 patients (control group - CG) without atherosclerosis of these branches but with coronary artery atherosclerosis. Diagnosis of erosive changes in the upper GI tract and verification of the source of gastrointestinal bleeding were confirmed by endoscopic examination. The severity of ulcer bleeding was assessed using a modified Forrest classification. The “REGATA” scale was used to assess the risk of gastrointestinal bleeding. Results: The MG patients showed a high frequency of gastric erosions (75.4%) against a background of diffuse (48.3%) or focal (45.9%) atrophy of the gastric mucosa. Gastric ulcers were diagnosed in 27.1% and duodenal ulcers in 12.7% of OG patients. The high risk of gastrointestinal bleeding according to the “REGATA” scale was observed in 77.1% of MG patients, which was significantly higher than in CG (64.2%) (p<0.05). Ulcer bleeding was identified in 16.1% of MG patients and 4.2% of CG patients. Combined endoscopic hemostasis was performed in all cases of gastrointestinal bleeding. Recurrent bleeding occurred in two cases. Conclusion: Patients with coronary artery disease and atherosclerosis of visceral branches of the abdominal aorta who receive long-term antiplatelet therapy are at high risk of gastrointestinal bleeding. Esophagogastroduodenoscopy (EGD) is the main method for diagnosing erosive-ulcerative lesions and identifying the source of bleeding. Endoscopic hemostasis effectively stops bleeding in the majority of cases.
About the Authors
A. G. Shuleshova
Central State Medical Academy of the Administration of the President of the Russian Federation
Russian Federation
Russian Federation
A. A. Lisitsa
Central State Medical Academy of the Administration of the President of the Russian Federation
Russian Federation
Russian Federation
D. V. Danilov
Central State Medical Academy of the Administration of the President of the Russian Federation
Russian Federation
Russian Federation
I. G. Repin
Central State Medical Academy of the Administration of the President of the Russian Federation
Russian Federation
Russian Federation
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Review
For citations:
Shuleshova A.G., Lisitsa A.A., Danilov D.V., Repin I.G. Non-variceal gastrointestinal bleeding in patients with cardiovascular diseases. Experimental and Clinical Gastroenterology. 2024;(8):28-36. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-228-8-28-36
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