Aortic Stenosis and Cryptogenic Gastrointestinal Bleeding: A Case-Control Study Involving 3,748 Patients
1996; Karger Publishers; Volume: 13; Issue: 3 Linguagem: Inglês
10.1159/000172432
ISSN1421-9883
AutoresAnastasios A. Mihas, Robert McEachern, David I. Bass, Menahen E. Shueke, James L. Achord,
Tópico(s)Antiplatelet Therapy and Cardiovascular Diseases
ResumoObjective: In a retrospective cohort study based on the analysis of clinical data abstracted from hospital charts, we determined whether an association exists between aortic stenosis and gastrointestinal bleeding of unknown etiology. Methods: A total of 3,748 patients admitted to the University and Veterans Administration Hospitals in Jackson, Miss., USA, over a 20-year period (1970-1989) were studied. Of these, 836 patients had aortic stenosis, 826 patients had mitral valve disease, and 2,086 presented with gastrointestinal bleeding and no evidence of cardiac valvular disease. Results: Cross-matching of the computer records revealed 11 and 3 patients admitted for gastrointestinal bleeding concomitant with aortic stenosis or mitral valve disease, respectively. Intensive chart review using strict inclusion criteria for idiopathic gastrointestinal bleeding reduced these numbers to 5 and 0, respectively. Statistical analysis revealed no significant difference between frequencies of idiopathic gastrointestinal bleeding with aortic stenosis (5/836) versus mitral valve disease (0/826; p = 0.0621). Similarly, the relative risk, although numerically high (10.87), was insignificant [95% confidence interval (0.602, 200.0)]. Conclusions: These data do not support the previously alleged association between aortic stenosis and gastrointestinal bleeding. However, considering the low study group numbers and especially since p = 0.06, such an association cannot be totally dismissed. We, therefore, believe that additional data will be needed before making any recommendations.
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