Gastrointestinal bleeding in cardiac patients: Epidemiology and evolving clinical paradigms

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6 Citations (Scopus)

Abstract

Purpose of review: Cardiac patients are a fast emerging population vulnerable to gastrointestinal bleeding (GIB) due to their use of antithrombotic medications. This review will quantify the GIB risk of cardiac patients prescribed antithrombotic medications, summarize risk-management strategies and highlight knowledge gaps. Recent findings: As the American population ages, it is anticipated that there will be an increased incidence of upper and lower GIB related to age-specific disease, higher burden of comorbidity and increased use of anticoagulants, antiplatelets and aspirin to treat cardiac disease. New evidence has highlighted the significant and clinically relevant GIB risk. The increased use of aggressive antiplatelet and anticoagulant therapies will alter our current understanding of the epidemiology of GIB. Summary: The magnitude of gastrointestinal risk in this vulnerable patient population is still relatively unexplored due to a paucity of literature. This review will highlight changing GIB trends and explore current knowledge regarding GIB risk in cardiac patients. An emphasis on a multidisciplinary approach to the care of these patients will be supported, which involves active patient participation and collaboration between cardiologists and gastroenterologists. Finally, risk-minimization strategies will be suggested and knowledge gaps will be identified.

Original languageEnglish (US)
Pages (from-to)609-614
Number of pages6
JournalCurrent Opinion in Gastroenterology
Volume30
Issue number6
DOIs
StatePublished - 2014

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Epidemiology
Hemorrhage
Vulnerable Populations
Anticoagulants
Patient Participation
Risk Management
Aspirin
Comorbidity
Heart Diseases
Patient Care
Incidence
Population

Keywords

  • Anticoagulant
  • Antiplatelet
  • Antithrombotic therapy
  • Cardiogastroenterology
  • Shared decision-making

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "Gastrointestinal bleeding in cardiac patients: Epidemiology and evolving clinical paradigms",
abstract = "Purpose of review: Cardiac patients are a fast emerging population vulnerable to gastrointestinal bleeding (GIB) due to their use of antithrombotic medications. This review will quantify the GIB risk of cardiac patients prescribed antithrombotic medications, summarize risk-management strategies and highlight knowledge gaps. Recent findings: As the American population ages, it is anticipated that there will be an increased incidence of upper and lower GIB related to age-specific disease, higher burden of comorbidity and increased use of anticoagulants, antiplatelets and aspirin to treat cardiac disease. New evidence has highlighted the significant and clinically relevant GIB risk. The increased use of aggressive antiplatelet and anticoagulant therapies will alter our current understanding of the epidemiology of GIB. Summary: The magnitude of gastrointestinal risk in this vulnerable patient population is still relatively unexplored due to a paucity of literature. This review will highlight changing GIB trends and explore current knowledge regarding GIB risk in cardiac patients. An emphasis on a multidisciplinary approach to the care of these patients will be supported, which involves active patient participation and collaboration between cardiologists and gastroenterologists. Finally, risk-minimization strategies will be suggested and knowledge gaps will be identified.",
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