Early Endoscopy for Acute Upper Gastrointestinal Bleeding in Acute Coronary Syndrome Patients

Launched by FAR EASTERN MEMORIAL HOSPITAL · Nov 29, 2015

Keywords

ClinConnect Summary

MATERIALS AND METHODS Study Design and Randomization A multicenter RCT of recent ACS patients presenting with acute UGIB was conducted in three tertiary centers (Far Eastern Memorial Hospital, Hsin-Chu Branch and Taipei Branch of National Taiwan University Hospital) in Taiwan. Patients with recent ACS, including unstable angina (UA), ST-elevation MI (STEMI) and non-ST elevation MI (NSTEMI) who presented symptoms of acute UGIB were evaluated for enrollment. The inclusion criteria were as follows: 1) age over 20-year-old, 2) ACS episodes in the past 2 weeks, 3) symptoms of UGIB including hema...

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Eligibility criteria

• Inclusion Criteria:
• • Patients with recent (\< 2 weeks) ACS and acute upper GI bleeding accompanied with a decrease in hemoglobin (Hb) level greater than 2 g/dl
• Exclusion Criteria (if any one of the following criteria is present):
• • Malignancy or other advanced disease with a life expectancy of \< 6 months
• • Pregnant or lactating women
• • History of allergy or severe side effects to PPIs, contrast, and iodine
• • Bleeding tendency, and platelet count \< 80k/uL, prothrombin time INR \>2.0
• • Decompensated liver cirrhosis (Child-Pugh classification B\~C) and esophagogastric varices history
• • Stage 3\~5 CKD (estimated Ccr \< 60 ml/min/1.73m2) using Cockcroft-Gault formula, exclusive of end-stage renal disease under renal replacement therapy
• • Stigmata of hemorrhage confirmed as lower GI tract bleeders
• • Without informed consents