Incidence and related factors of upper gastrointestinal bleeding in a Chinese population of peripheral arterial disease during a six-year follow-up.
OBJECTIVE
The aim of the study was to investigate the incidence and related factors of upper gastrointestinal bleeding (UGIB) in a Chinese population of peripheral arterial disease (PAD).


METHODS
A total of 850 Chinese PAD patients were followed up for about 6 years. The incidence of UGIB was recorded and related factors were evaluated


RESULTS
A total of 749 PAD patients with complete data were included in the final statistical analysis during the median follow-up time of 69 months. The incidence of UGIB in this PAD population was 8.4% during the follow-up. Univariate analysis indicated that PAD patients with UGIB were older. A higher percentage of patients with UGIB had hypertension, CKD, history of PUD, and used aspirin or warfarin than those without UGIB. But a lower percentage of patients with UGIB used PPI. The Cox regression analysis suggested that older age (HR: 1.035, 95% CI: 1.007-1.064), comorbidities of CKD (HR: 2.410, 95% CI: 1.455-3.993), history of PUD (HR: 2.127, 95% CI: 1.102-4.100), use of aspirin (HR: 1.517, 95% CI: 1.029-2.235) or warfarin (HR: 1.576, 95% CI: 1.002-2.252) were correlated with the higher incidence of UGIB in PAD patients during follow-up. Nevertheless, PPI use (HR: 0.612, 95% CI: 0.392-0.957) was correlated with the lower incidence of UGIB.


CONCLUSIONS
There was a high incidence of UGIB in this Chinese population of PAD. Various factors including older age, comorbidities of CKD, history of PUD, use of aspirin or warfarin were correlated with the higher incidence of UGIB. PPI use was able to reduce the incidence of UGIB.
Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China - sulongwy@sina.com.
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Guo
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Wang
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Wang
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Ma
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Hao
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Li
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects; D001241:Aspirin / Q000009:adverse effects; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000208:ethnology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000208:ethnology; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology*; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000208:ethnology; D012307:Risk Factors; D013997:Time Factors; D014859:Warfarin / Q000009:adverse effects
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D014859:Warfarin; D001241:Aspirin