title: Gastrointestinal bleeding in cardiac patients: epidemiology and evolving clinical paradigms.
abstract: OBJECTIVE
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: aDivision of Gastroenterology, Department of Medicine, Scottsdale, Arizona bDivision of Healthcare Policy and Research, Department of Health Services Research, Rochester, Minnesota, USA.
authors.forename: Neena S
authors.initials: NS
authors.lastname: Abraham
mesh_terms: D000367:Age Factors; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control; D006331:Heart Diseases / Q000188:drug therapy* / Q000453:epidemiology; D016558:Hemostasis, Endoscopic; D006801:Humans; D015994:Incidence; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin