Clinical Analysis Of Upper Gastrointestinal Tract Injury Associated With Dual Antiplatelet Therapy After Percutaneous Coronary Intervention(PCI)

Objective: To investigate the clinical characteristics and influencing factors of upper digestive tract injury in patients with acute coronary syndrome(ACS)who were admin-istrated with dual antiplatelet therapy after percutaneous coronary intervention(PCI).Methods: A retrospective review of 193 cases of ACS patients who were administrate-d with dual antiplatelet therapy after PCI admitted to our hospital from September 2018 to September 2019.The incidence upper digestive tract symptoms and clinical characteristics of ACS patients on dual antiplatelet therapy for 1 year after PCI were analyzed,and the risk factors for upper gastrointestinal symptoms and peptic ulcer after PCI were analyzed.Results:1.A total of 193 patients were included in this survey.There were 152 males and 41 females in the study.The ratio of men to women is 3.71:1.The average age was62.87±11.02 years.There were 82 persons had upper gastrointestinal symptoms(42.49%).The main manifestations were upper abdominal discomfort in 26 patients(13.47%%),upper abdominal distension in 25 patients(12.95%),acid reflux and heartburn in 17 patients(8.80%),belching in 16 patients(8.29%),upper abdominal pain in 9 patients(4.66%),upper gastrointestinal bleeding in 8 patients(4.15%),and nausea and vomiting in 3 patients(1.55%).2.This group of 56 patients with routine gastroscopy,31 patients(55.36%)had chronic gastritis,24 patients(42.86%)had peptic ulcer,13 patients(16.07%)had Gastric debaucjed,3 patients(5.36%)had reflux esophagitis,including 11 patients(35.48%)had asymptomatic gastrointestinal injury,38 patients(19.69%)had HP detection.There were19 patients(50.00%)of positive and negative HP test results.3.Among the 193 patients in this group,89(46.11%)were treated with proton pump inhibitor,and 8(4.15%)were treated with H2 receptor antagonist and gastric mucosal protectant.4.Logistic regression analysis of risk factors for upper gastrointestinal symptoms in patients taking dual antiplatelet drugs showed that women(OR= 0.03,95%ci0.01-0.10,P< 0.05),previous history of upper gastrointestinal diseases(OR=2.96,95%ci1.32-6.64,P< 0.01),and smoking history(OR= 4.86,95% ci1.96-12.08,P< 0.01)were risk factors for upper gastrointestinal symptoms.5.The risk factors for peptic ulcer in patients taking dual antiplatelet drugs were analyzed by logistic regression: HP infection(OR= 4.83,95% ci1.58-14.83,P<0.01),previous history of upper gastrointestinal diseases(OR=8.43,95% ci1.41-50.43,P< 0.05)were risk factors for peptic ulcer disease.Conclusion:In this study,the upper gastrointestinal symptoms of the patients taking dual antiplatelet drugs were mainly non-specific,and the incidence of upper abdominal pain was low.The incidence of upper gastrointestinal bleeding and peptic ulcer was higher than that of general population.The prevalence of HP infection was similar to that of the general population.Only half of the patients in this group were taking PPI at the same time.The risk factors of upper gastrointestinal symptoms were female,smoking and history of upper gastrointestinal diseases.HP infection and history of upper gastrointestinal diseases were risk factors for peptic ulcer in this group.