{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T21:00:13Z","timestamp":1789506013412,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,5,9]],"date-time":"2017-05-09T00:00:00Z","timestamp":1494288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2017,7]]},"abstract":"Summary<\/jats:title>\n \n Background<\/jats:title>\n \n Patients with coronary artery disease (\n CAD<\/jats:styled-content>\n ) treated with stents require dual antiplatelet therapy (\n DAPT<\/jats:styled-content>\n ). For cirrhotics, who often have varices and coagulopathy, it is not clear if the risk of gastrointestinal bleeding (\n GIB<\/jats:styled-content>\n ) should preclude use of\n DAPT<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n \n To compare\n GIB<\/jats:styled-content>\n and mortality rates in cirrhotics with\n CAD<\/jats:styled-content>\n treated medically or with stents.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Using institutional databases, we identified patients with cirrhosis and\n CAD<\/jats:styled-content>\n treated with stents or medical therapy between January 2000\u2010September 2015. Primary outcomes were\n GIB<\/jats:styled-content>\n and mortality.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We identified 148 cirrhotics with\n CAD<\/jats:styled-content>\n ; 68 received stents (cases), 80 were treated with medical therapy (controls). Cases and controls had similar demographics, comorbidities,\n MELD<\/jats:styled-content>\n scores and clinical presentation;\n DAPT<\/jats:styled-content>\n was used in 98.5% of cases vs 5% of controls. The incidence of\n GIB<\/jats:styled-content>\n was significantly higher in cases than controls (22.1% vs 5% at 1 year,\n P<\/jats:italic>\n =.003; 27.9% vs 5% at 2 years,\n P<\/jats:italic>\n =.0002), whereas all\u2010cause mortality was similar (20.6% vs 21.3%). No patient required surgery or angiography for\n GIB<\/jats:styled-content>\n , and no known patients died due to\n GIB<\/jats:styled-content>\n . Multivariate analysis revealed use of a proton pump inhibitor (\n PPI<\/jats:styled-content>\n ) was highly protective against\n GIB<\/jats:styled-content>\n (\n OR<\/jats:styled-content>\n =0.26, 95%\n CI<\/jats:styled-content>\n =0.08\u20100.79).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n CAD<\/jats:styled-content>\n treatment with stents in our cirrhotics was associated with a significantly increased risk of\n GIB<\/jats:styled-content>\n , but no adverse effects on survival. Although it remains unclear whether the cardiovascular benefits of stents outweigh the\n GIB<\/jats:styled-content>\n risk, our findings suggest that\n DAPT<\/jats:styled-content>\n should not be withheld from stented cirrhotics for fear of\n GIB<\/jats:styled-content>\n . Moreover, the use of a\n PPI<\/jats:styled-content>\n should be strongly considered.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/apt.14121","type":"journal-article","created":{"date-parts":[[2017,5,10]],"date-time":"2017-05-10T00:33:05Z","timestamp":1494376385000},"page":"183-192","source":"Crossref","is-referenced-by-count":52,"title":["Patients with cirrhosis who have coronary artery disease treated with cardiac stents have high rates of gastrointestinal bleeding, but no increased mortality"],"prefix":"10.1111","volume":"46","author":[{"given":"T.","family":"Krill","sequence":"first","affiliation":[{"name":"Division of Digestive and Liver Disease VA North Texas Healthcare System Dallas TX USA"},{"name":"Division of Digestive and Liver Diseases University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Digestive and Liver Disease VA North Texas Healthcare System Dallas TX USA"},{"name":"Division of Digestive and Liver Diseases University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. A.","family":"Weideman","sequence":"additional","affiliation":[{"name":"Department of Pharmacy VA North Texas Healthcare System Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. J.","family":"Cipher","sequence":"additional","affiliation":[{"name":"College of Nursing and Health Innovation University of Texas at Arlington Arlington TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. J.","family":"Spechler","sequence":"additional","affiliation":[{"name":"Division of Digestive and Liver Disease VA North Texas Healthcare System Dallas TX USA"},{"name":"Division of Digestive and Liver Diseases University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Brilakis","sequence":"additional","affiliation":[{"name":"Division of Cardiology VA North Texas Healthcare System Dallas TX USA"},{"name":"Division of Cardiology University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7758-3257","authenticated-orcid":false,"given":"L. A.","family":"Feagins","sequence":"additional","affiliation":[{"name":"Division of Digestive and Liver Disease VA North Texas Healthcare System Dallas TX USA"},{"name":"Division of Digestive and Liver Diseases University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,5,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/jlts.2001.26063"},{"key":"e_1_2_7_3_1","first-page":"567","article-title":"Atherosclerosis and cirrhosis of the liver","volume":"53","author":"Vanecek R","year":"1976","journal-title":"Bull World Health Organ"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-195510000-00004"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(60)90192-7"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-009-0738-z"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199503270-00010"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.01.089"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e318157188e"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.500040415"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199604270-00011"},{"key":"e_1_2_7_12_1","first-page":"e38","article-title":"Heart Disease and Stroke Statistics\u20102016 update: a report from the American Heart Association","volume":"133","author":"Writing Group M","year":"2016","journal-title":"Circulation"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.09090769"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23789"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2008.05.024"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e3182371258"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1089253210386244"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e3181faec3c"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010746"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.7.853"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.48.2031"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.22301"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20398"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.22591"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2008.10.037"}],"container-title":["Alimentary Pharmacology & Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.14121","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.14121","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T14:45:07Z","timestamp":1695393907000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.14121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,9]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1111\/apt.14121"],"URL":"https:\/\/doi.org\/10.1111\/apt.14121","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,9]]}}}