open access

Vol 19, No 5 (2012)
Review paper
Published online: 2012-10-06
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Safety of endoscopic procedures after acute myocardial infarction: A systematic review

Marek Cena, Javier Gomez, Tareq Alyousef, Richard G. Trohman, Krzysztof Pierko, Rajender Agarwal
DOI: 10.5603/CJ.2012.0083
·
Cardiol J 2012;19(5):447-452.

open access

Vol 19, No 5 (2012)
Review articles
Published online: 2012-10-06

Abstract


Background: The management of patients who develop gastrointestinal (GI) bleeding after acute myocardial infarction (MI) is difficult due to concerns about possible cardiovascular complications. Gastroenterologists are often reluctant to perform endoscopic procedures despite urgent indications. We performed a systematic review of the literature to determine the safety of endoscopic procedures after MI.
Methods: We searched MEDLINE, EMBASE and the Cochrane Central Register of Controlled trials for controlled clinical trials or case series examining the diagnostic efficacy and complications of esophagogastroduodenoscopy (EGD), colonoscopy and flexible sigmoidoscopy after MI. Title and abstract screening was followed by full-text review with subsequent data extraction of included studies.
Results: A total of seven studies met inclusion criteria. Four studies evaluated safety and efficacy of EGD after MI. The reported complication rate ranged between 1-8%, with a large predominance of minor complications. We found one study addressing safety of flexible sigmoidoscopy that reported minor complications in two patients. We also identified one study addressing the safety of colonoscopy after MI, which showed a complication rate of 9%. Most of these complications were minor. A decision analysis was also included in this review.
Conclusions: Our review demonstrated that endoscopic procedures are safe and beneficial in stable patients with GI bleeding after recent MI and should be performed without a requisite delay. Unstable patients should undergo endoscopic procedures only in the intensive care setting, after stabilization and with close monitoring. (Cardiol J 2012; 19, 5: 447-452)

Abstract


Background: The management of patients who develop gastrointestinal (GI) bleeding after acute myocardial infarction (MI) is difficult due to concerns about possible cardiovascular complications. Gastroenterologists are often reluctant to perform endoscopic procedures despite urgent indications. We performed a systematic review of the literature to determine the safety of endoscopic procedures after MI.
Methods: We searched MEDLINE, EMBASE and the Cochrane Central Register of Controlled trials for controlled clinical trials or case series examining the diagnostic efficacy and complications of esophagogastroduodenoscopy (EGD), colonoscopy and flexible sigmoidoscopy after MI. Title and abstract screening was followed by full-text review with subsequent data extraction of included studies.
Results: A total of seven studies met inclusion criteria. Four studies evaluated safety and efficacy of EGD after MI. The reported complication rate ranged between 1-8%, with a large predominance of minor complications. We found one study addressing safety of flexible sigmoidoscopy that reported minor complications in two patients. We also identified one study addressing the safety of colonoscopy after MI, which showed a complication rate of 9%. Most of these complications were minor. A decision analysis was also included in this review.
Conclusions: Our review demonstrated that endoscopic procedures are safe and beneficial in stable patients with GI bleeding after recent MI and should be performed without a requisite delay. Unstable patients should undergo endoscopic procedures only in the intensive care setting, after stabilization and with close monitoring. (Cardiol J 2012; 19, 5: 447-452)
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Keywords

endoscopy; myocardial infarction; systematic review

About this article
Title

Safety of endoscopic procedures after acute myocardial infarction: A systematic review

Journal

Cardiology Journal

Issue

Vol 19, No 5 (2012)

Article type

Review paper

Pages

447-452

Published online

2012-10-06

DOI

10.5603/CJ.2012.0083

Bibliographic record

Cardiol J 2012;19(5):447-452.

Keywords

endoscopy
myocardial infarction
systematic review

Authors

Marek Cena
Javier Gomez
Tareq Alyousef
Richard G. Trohman
Krzysztof Pierko
Rajender Agarwal

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