Bleeding complications rise after heart attacks as major cardiovascular events decline
People who have survived a heart attack have gained increasingly better protection against new serious cardiovascular events over the past two decades. At the same time, the risk of bleeding complications has increased. A new study by researchers at Karolinska Institutet shows that bleeding in the gastrointestinal tract is the most common type of serious bleeding after a heart attack.
A new study from Karolinska Institutet reveals a rise in bleeding complications for patients who have experienced a heart attack, despite a decline in major cardiovascular events over the past two decades. The research, published in the European Journal of Preventive Cardiology, found that gastrointestinal bleeding became the most common type of serious bleeding following a heart attack.
Researchers analyzed data from the SWEDEHEART registry, focusing on patients discharged alive on antithrombotic treatment between 1999 and 2020. Over the study period, the incidence of major adverse cardiovascular events, such as recurrent myocardial infarction, stroke, and death, decreased significantly, from 20.1% to 9.4%. However, the proportion of patients requiring hospitalization for bleeding rose from 2.4% to 4.5%.
The most frequent source of bleeding was the gastrointestinal tract, particularly the upper gastrointestinal tract, including the esophagus, stomach, or duodenum. Study co-author Jonatan Wärme, a doctoral student, explained that treatment strategies have evolved, with increased use of coronary interventions, dual antiplatelet therapy, more potent antithrombotic medications, and direct oral anticoagulants.
These changes in treatment may be contributing to the increased incidence of upper gastrointestinal bleeding. The researchers emphasize the importance of tailoring antithrombotic therapy to individual patient risk profiles and implementing measures to protect the gastrointestinal tract.
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