Gastrointestinal Bleeding Risk Associated With Pulse Pressure in Patients With Atrial Fibrillation: Retrospective Cohort Study - Report - MDSpire

Association Between Pulse Pressure and Gastrointestinal Bleeding Risk in Atrial Fibrillation Patients: A Retrospective Cohort Analysis

  • By

  • Michel Abou Khalil

  • Carlo El Khoury

  • Yishi Jia

  • Maximilian Moersdorf

  • Christian Massad

  • Alex El Darzi

  • Yara Menassa

  • Mohammad Montaser Atasi

  • Ghassan Bidaoui

  • Hadi Younes

  • Ala Assaf

  • Mario Mekhael

  • Eli Tsakiris

  • Chanho Lim

  • Charbel Noujaim

  • Abboud Hassan

  • Yingshuo Liu

  • Mary Margot M Maleckar

  • Rodolfo A Montiel Quintero

  • Omar Kreidieh

  • Amitabh C Pandey

  • Han Feng

  • Qussay Marashly

  • Nassir F Marrouche

  • July 20, 2026

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Clinical Report: Association Between Pulse Pressure and GI Bleeding Risk in AF Patients

Overview

This study investigates the relationship between pulse pressure and the risk of gastrointestinal bleeding in patients with atrial fibrillation.

Background

Atrial fibrillation (AF) is a prevalent cardiac arrhythmia that significantly increases the risk of thromboembolic stroke, necessitating the use of oral anticoagulation (OAC) for prevention. However, OAC therapy is associated with serious bleeding complications, particularly gastrointestinal bleeding, which can lead to adverse outcomes. Accurate bleeding risk stratification is crucial for optimizing patient management and minimizing complications.

Data Highlights

No numerical data or trial data provided in the source material.

Key Findings

  • Pulse pressure (PP) is defined as the difference between systolic and diastolic blood pressure.
  • Current bleeding risk scores have limitations in accurately stratifying bleeding risk in AF patients.
  • There is a need for novel markers to enhance bleeding risk assessment in patients on anticoagulation therapy.
  • Gastrointestinal bleeding is a significant concern in patients receiving OAC, impacting treatment adherence and outcomes.
  • Clinical guidelines emphasize the management of modifiable bleeding risk factors in AF patients.

Clinical Implications

Clinicians should consider pulse pressure as a potential factor in assessing bleeding risk among patients with atrial fibrillation. Enhanced risk stratification may improve management strategies and patient outcomes in those receiving anticoagulation therapy.

Conclusion

The study highlights the potential role of pulse pressure in evaluating gastrointestinal bleeding risk in atrial fibrillation patients, indicating a need for further investigation into its clinical utility.

Related Resources & Content

  1. Tan S, Zhou J, Veang T, et al., Europace, 2025 -- Global, regional, and national burden of atrial fibrillation and atrial flutter from 1990 to 2021
  2. Burdett P, Lip GYH, Eur Heart J Qual Care Clin Outcomes, 2022 -- Atrial fibrillation in the UK: predicting costs of an emerging epidemic
  3. Chao TF, Lip GYH, Lin YJ, et al., Int J Cardiol, 2018 -- Major bleeding and intracranial hemorrhage risk prediction in patients with atrial fibrillation
  4. Wang X, Pan MM, Wang J, et al., J Thromb Haemost, 2026 -- Identifying risk factors for major bleeding in patients with atrial fibrillation using direct oral anticoagulants
  5. Frontiers in Cardiovascular Medicine — Risk factors of bleeding in patients with atrial fibrillation undergoing percutaneous coronary intervention: an analysis from the MANJUSRI study
  6. European Journal of Preventive Cardiology — Risk factors associated with gastrointestinal bleeding in patients with cardiovascular disease (INTERBLEED): a case control study
  7. European Journal of Preventive Cardiology — Bleeding in atrial fibrillation: unavoidable risk or modifiable target?
  8. Frontiers in Cardiovascular Medicine — Association between blood pressure levels and risk of stroke in patients with atrial fibrillation: results from a prospective registry in Xinjiang, China
  9. 2024 Atrial Fibrillation Guidelines
  10. Direct-acting oral anticoagulants versus warfarin in relation to risk of gastrointestinal bleeding
  11. The association between proton pump inhibitors and the risk of gastrointestinal bleeding in oral anticoagulants users | npj Cardiovascular Health

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