Prevention & lipids

Risk factors associated with gastrointestinal bleeding in patients with cardiovascular disease (INTERBLEED): a case control study

Eur J Prev CardiolPublished Case-control study

Authors' conclusion

Potentially modifiable risk factors are associated with only about one third of the aPAF for GI bleeding.

Study context

Population
Patients with CVD
Participants
2,519 vs 2,202
Comparison
Patients with CVD with gastrointestinal (GI) bleeding vs without a history of GI bleeding
  • Casesn = 2,519
  • Controlsn = 2,202reference
Outcome
Risk factors for GI bleeding (adjusted ORs and average population attributable fractions, average population attributable fractions (aPAFs))
Methodological details9 countries in Asia, America, Europe and Australia, Enrolment September 2015 to December 2022
  • 9 countries in Asia, America, Europe and Australia
  • Enrolment September 2015 to December 2022

Main finding

As reported in the abstract

Independent risk factors for GI bleeding
Odds ratio (95% CI)
Age 71+vs Age ≤60
4.16(3.48–4.97)
Age 61-70vs Age ≤60
1.69(1.39–2.04)
UnderweightaPAF 1.6%, 95% CI 1.0-2.0%
3.38(2.24–5.10)
Current smokeraPAF 1.5%, 95% CI 0.6-2.5
1.31(1.09–1.58)
Chronic kidney diseaseaPAF 8.8%, 95% CI 7.0-9.6%
1.86(1.62–2.14)
Prior strokeaPAF 2.6%, 95% CI 1.2-4.0%
1.56(1.30–1.88)
GlucocorticoidsaPAF 1.8%, 95% CI 1.3-2.9%
1.71(1.34–2.16)
NSAIDs or COX-2 inhibitorsaPAF 2.2%, 95% CI 1.3-3.0%
1.82(1.45–2.29)
Liver diseaseaPAF 3.5%, 95% CI 2.8-4.2%
3.68(2.77–4.89)
Peptic ulcer diseaseaPAF 4.8%, 95% CI 3.8-5.7%
3.38(2.66–4.31)
Diverticular diseaseaPAF 2.8%, 1.9-3.6%
1.81(1.46–2.24)
Antithrombotic therapy within 6 months, aPAF
7.6%, 95% CI 4.3-12.8%
Overall aPAF adjusted for age, sex and region
37.3% (95% CI 33.0-42.2%)

Observational data: associations, not effects.

Original publication

Risk factors associated with gastrointestinal bleeding in patients with cardiovascular disease (INTERBLEED): a case control study. Eur J Prev Cardiol. Published 14 May 2025. doi:10.1093/eurjpc/zwaf300

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