Prevention & lipidsCase-control study
Risk factors associated with gastrointestinal bleeding in patients with cardiovascular disease (INTERBLEED): a case control study
- Case-control study
- 9 countries in Asia, America, Europe and Australia
- Enrolment September 2015 to December 2022
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))
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 61-70 vs Age ≤60
1.69(1.39–2.04)
Underweight vs ControlsaPAF 1.6%, 95% CI 1.0-2.0%
3.38(2.24–5.10)
Current smoker vs ControlsaPAF 1.5%, 95% CI 0.6-2.5
1.31(1.09–1.58)
Chronic kidney disease vs ControlsaPAF 8.8%, 95% CI 7.0-9.6%
1.86(1.62–2.14)
Prior stroke vs ControlsaPAF 2.6%, 95% CI 1.2-4.0%
1.56(1.30–1.88)
Glucocorticoids vs ControlsaPAF 1.8%, 95% CI 1.3-2.9%
1.71(1.34–2.16)
NSAIDs or COX-2 inhibitors vs ControlsaPAF 2.2%, 95% CI 1.3-3.0%
1.82(1.45–2.29)
Liver disease vs ControlsaPAF 3.5%, 95% CI 2.8-4.2%
3.68(2.77–4.89)
Peptic ulcer disease vs ControlsaPAF 4.8%, 95% CI 3.8-5.7%
3.38(2.66–4.31)
Diverticular disease vs ControlsaPAF 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
Summarised from the published abstract; every number is checked against it