Abstract 9747: Gastrointestinal Bleeding in Acute Myocardial Infarction Patients Undergoing Coronary Artery Bypass Graft Surgery; A National Study

Abstract

Introduction: While gastrointestinal (GI) bleeding is a possible surgical complication, there is a paucity of information on the incidence and risk among Acute Myocardial Infarction (AMI) patients undergoing Coronary artery bypass graft surgery (CABG). Methods: We queried the 2019 National Inpatient Sample to identify cases of GI bleeding among AMI patients undergoing CABG. Patient characteristics and risk factors were estimated using multiple logistic regression. Results: Our analysis found that 48590 patients with AMI underwent CABG, and 865 (1.8%) gastrointestinal bleeding events were recorded. It was more prevalent among Whites (aOR 1.462, p=0.012) and Hispanics (aOR 2.436, p<0.01), patients of ages >60 (aOR 1.591, p<0.01), with a diagnosis of supraventricular tachycardia (aOR 1.688, p<0.01), paroxysmal atrial fibrillation (aOR 1.670, p<0.01), cirrhosis (aOR 3.363, p<0.01), acute kidney injury (aOR 1.864, p<0.01), covered by Medicare (aOR 1.494, p=0.010), and with peripheral vascular disease (aOR 1.731, p<0.01). Meanwhile, patients with hypertension (aOR 0.573, p<0.01), smokers (aOR 0.744, p<0.01), hyperlipidemia (aOR 0.477, p<0.01), and obesity (aOR0.799, p<0.01) reported lower risks. A mortality rate of 12.7% was observed. Females (aOR 1.967, p=0.017), cirrhosis (aOR 5.521, p<0.01), acute kidney injury (aOR 3.657, p<0.01), ventricular tachycardia (aOR 2.002, p=0.033), paroxysmal atrial fibrillation (aOR 2.535, p<0.01), and hyperkalemia (aOR 2.397, p=0.013) predisposed to greater inpatient deaths, while diabetes (aOR 0. 491, p<0.01) and hyperlipidemia (aOR 0. 198, p<0.01) showed a reduced risk. Finally, a higher overall risk of inpatient death was seen among AMI patients who underwent CABG if they had GI bleeding (aOR 2.674, p<0.01). Conclusions: GI bleeding can lead to a poor outcome among AMI patients who underwent CABG during their hospitalization. We also found several factors predisposing these patients to such events.