Risk factors associated with Gastrointestinal Bleeding in Patients with Cardiovascular Disease (INTERBLEED): a case control study.

IF 8.4 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

European journal of preventive cardiology Pub Date : 2025-05-14 DOI:10.1093/eurjpc/zwaf300

Jacqueline Bosch, Martin O'Donnell, Qilong Yi, Paul Moayyedi, Marco Alings, Alvaro Avezum, Shrikant I Bangdiwala, Alan Barkun, Federico Cassella, Aloisio Marchi da Rocha, Irfan Duzen, Robert Enns, Nauzer Forbes, Leah Hamilton, Mustafa Kilickap, Paul Kruger, Yan Liang, Jose C Nicolau, Rafael Belo Nunes, Gustavo Oliviera, Alejandro Rey, Islam Shofiqul, Yihong Sun, Thomas Vanassche, Peter Verhamme, Michael Walsh, Zhenyu Wang, Cynthia Wu, Li Zhao, Jun Zhu, John W Eikelboom

{"title":"Risk factors associated with Gastrointestinal Bleeding in Patients with Cardiovascular Disease (INTERBLEED): a case control study.","authors":"Jacqueline Bosch, Martin O'Donnell, Qilong Yi, Paul Moayyedi, Marco Alings, Alvaro Avezum, Shrikant I Bangdiwala, Alan Barkun, Federico Cassella, Aloisio Marchi da Rocha, Irfan Duzen, Robert Enns, Nauzer Forbes, Leah Hamilton, Mustafa Kilickap, Paul Kruger, Yan Liang, Jose C Nicolau, Rafael Belo Nunes, Gustavo Oliviera, Alejandro Rey, Islam Shofiqul, Yihong Sun, Thomas Vanassche, Peter Verhamme, Michael Walsh, Zhenyu Wang, Cynthia Wu, Li Zhao, Jun Zhu, John W Eikelboom","doi":"10.1093/eurjpc/zwaf300","DOIUrl":null,"url":null,"abstract":"Aims: This study aimed to identify and quantify the importance of risk factors for gastrointestinal (GI) bleeding in patients with CV disease.Methods: We conducted a case-control study in 9 countries in Asia, America, Europe, and Australia. Cases were patients with CV disease with GI bleeding. Controls were patients with CV without a history of GI bleeding. All participants completed a baseline standardized assessment. We calculated adjusted odds ratios (ORs) and average population attributable fractions (aPAFs) with 95% confidence intervals (CIs).Results: Between September 2015 and December 2022, we enrolled 2,519 cases and 2,202 controls. Independent risk factors for GI bleeding were age (age 71+: OR 4.16, 95% CI 3.48-4.97; age 61-70: OR 1.69, 95% CI 1.39-2.04; age ≤60 as reference), underweight (OR 3.38, 95% CI 2.24-5.10; aPAF 1.6%, 95% CI 1.0-2.0%), current smoker (OR 1.31; 95% CI 1.09-1.58; aPAF 1.5%, 95% CI 0.6-2.5); chronic kidney disease (OR 1.86, 95% CI 1.62-2.14; aPAF 8.8%, 95% CI 7.0-9.6%), prior stroke (OR 1.56, 95% CI 1.30-1.88, aPAF 2.6%, 95% CI 1.2-4.0%), glucocorticoids (OR 1.71, 95% CI 1.34-2.16, aPAF 1.8%, 95% CI 1.3-2.9%), NSAIDs or COX-2 inhibitors (OR 1.82, 95% CI 1.45-2.29; aPAF 2.2%, 95% CI 1.3-3.0%), liver disease (OR 3.68, 95% CI 2.77-4.89; aPAF 3.5%, 95% CI 2.8-4.2%), peptic ulcer disease (OR 3.38, 95% CI 2.66-4.31; aPAF 4.8%, 95% CI 3.8-5.7%), diverticular disease (OR 1.81, 95% CI 1.46-2.24; aPAF 2.8%, 1.9-3.6%) and antithrombotic therapy within 6 months (aPAF 7.6%, 95% CI 4.3-12.8%). Overall aPAF adjusted for age, sex and region was 37.3% (95% CI 33.0-42.2%).Conclusion: Potentially modifiable risk factors are associated with only about one third of the aPAF for GI bleeding.","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4000,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of preventive cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/eurjpc/zwaf300","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Aims: This study aimed to identify and quantify the importance of risk factors for gastrointestinal (GI) bleeding in patients with CV disease.

Methods: We conducted a case-control study in 9 countries in Asia, America, Europe, and Australia. Cases were patients with CV disease with GI bleeding. Controls were patients with CV without a history of GI bleeding. All participants completed a baseline standardized assessment. We calculated adjusted odds ratios (ORs) and average population attributable fractions (aPAFs) with 95% confidence intervals (CIs).

Results: Between September 2015 and December 2022, we enrolled 2,519 cases and 2,202 controls. Independent risk factors for GI bleeding were age (age 71+: OR 4.16, 95% CI 3.48-4.97; age 61-70: OR 1.69, 95% CI 1.39-2.04; age ≤60 as reference), underweight (OR 3.38, 95% CI 2.24-5.10; aPAF 1.6%, 95% CI 1.0-2.0%), current smoker (OR 1.31; 95% CI 1.09-1.58; aPAF 1.5%, 95% CI 0.6-2.5); chronic kidney disease (OR 1.86, 95% CI 1.62-2.14; aPAF 8.8%, 95% CI 7.0-9.6%), prior stroke (OR 1.56, 95% CI 1.30-1.88, aPAF 2.6%, 95% CI 1.2-4.0%), glucocorticoids (OR 1.71, 95% CI 1.34-2.16, aPAF 1.8%, 95% CI 1.3-2.9%), NSAIDs or COX-2 inhibitors (OR 1.82, 95% CI 1.45-2.29; aPAF 2.2%, 95% CI 1.3-3.0%), liver disease (OR 3.68, 95% CI 2.77-4.89; aPAF 3.5%, 95% CI 2.8-4.2%), peptic ulcer disease (OR 3.38, 95% CI 2.66-4.31; aPAF 4.8%, 95% CI 3.8-5.7%), diverticular disease (OR 1.81, 95% CI 1.46-2.24; aPAF 2.8%, 1.9-3.6%) and antithrombotic therapy within 6 months (aPAF 7.6%, 95% CI 4.3-12.8%). Overall aPAF adjusted for age, sex and region was 37.3% (95% CI 33.0-42.2%).

Conclusion: Potentially modifiable risk factors are associated with only about one third of the aPAF for GI bleeding.

查看原文本刊更多论文

与心血管疾病患者胃肠道出血相关的危险因素（INTERBLEED）：一项病例对照研究

目的：本研究旨在确定和量化心血管疾病患者胃肠道（GI）出血危险因素的重要性。方法：我们在亚洲、美洲、欧洲和澳大利亚的9个国家进行了病例对照研究。病例为伴有消化道出血的CV病患者。对照组为无消化道出血史的CV患者。所有参与者都完成了基线标准化评估。我们计算了校正优势比（ORs）和95%置信区间（CIs）的平均人群归因分数（aPAFs）。结果：2015年9月至2022年12月，我们纳入了2519例病例和2202例对照。胃肠道出血的独立危险因素为年龄(71岁以上：OR 4.16, 95% CI 3.48-4.97；年龄61-70岁：OR 1.69, 95% CI 1.39-2.04；年龄≤60岁)、体重过轻(OR 3.38, 95% CI 2.24-5.10；aPAF 1.6%, 95% CI 1.0-2.0%)，当前吸烟者(OR 1.31；95% ci 1.09-1.58；aPAF 1.5%, 95% CI 0.6-2.5)；慢性肾病(OR 1.86, 95% CI 1.62-2.14；aPAF 8.8%, 95% CI 7.0-9.6%)，既往卒中（OR 1.56, 95% CI 1.30-1.88, aPAF 2.6%, 95% CI 1.2-4.0%），糖皮质激素（OR 1.71, 95% CI 1.34-2.16, aPAF 1.8%, 95% CI 1.3-2.9%），非甾体抗炎药或COX-2抑制剂(OR 1.82, 95% CI 1.45-2.29；aPAF 2.2%, 95% CI 1.3-3.0%)，肝脏疾病(OR 3.68, 95% CI 2.77-4.89；aPAF 3.5%, 95% CI 2.8-4.2%)，消化性溃疡疾病(OR 3.38, 95% CI 2.66-4.31；aPAF 4.8%, 95% CI 3.8-5.7%)，憩室病(OR 1.81, 95% CI 1.46-2.24；aPAF 2.8%, 1.9-3.6%)和6个月内的抗血栓治疗（aPAF 7.6%, 95% CI 4.3-12.8%）。经年龄、性别和地区调整后的aPAF总体为37.3% （95% CI 33.0-42.2%）。结论：潜在可改变的危险因素仅与三分之一的aPAF与胃肠道出血有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European journal of preventive cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

12.50

自引率

12.00%

发文量

601

审稿时长

3-8 weeks

期刊介绍： European Journal of Preventive Cardiology (EJPC) is an official journal of the European Society of Cardiology (ESC) and the European Association of Preventive Cardiology (EAPC). The journal covers a wide range of scientific, clinical, and public health disciplines related to cardiovascular disease prevention, risk factor management, cardiovascular rehabilitation, population science and public health, and exercise physiology. The categories covered by the journal include classical risk factors and treatment, lifestyle risk factors, non-modifiable cardiovascular risk factors, cardiovascular conditions, concomitant pathological conditions, sport cardiology, diagnostic tests, care settings, epidemiology, pharmacology and pharmacotherapy, machine learning, and artificial intelligence.