Inpatient Outcomes of Gastric Antral Vascular Ectasia in Those With Aortic Stenosis: A Retrospective Study of 85,000 Hospitalizations

Mohammad Aldiabat; Yassine Kilani; Majd Alahmad; Laith Alhuneafat; Yazan Aljabiri; Ali Horoub; Khaled Alabdallah; Hebah Alrahamneh; Amar Manvar

doi:10.1097/MCG.0000000000001932

Inpatient Outcomes of Gastric Antral Vascular Ectasia in Those With Aortic Stenosis: A Retrospective Study of 85,000 Hospitalizations

J Clin Gastroenterol. 2023 Oct 2. doi: 10.1097/MCG.0000000000001932. Online ahead of print.

Authors

Mohammad Aldiabat¹, Yassine Kilani², Majd Alahmad³, Laith Alhuneafat⁴, Yazan Aljabiri¹, Ali Horoub⁵, Khaled Alabdallah⁶, Hebah Alrahamneh⁷, Amar Manvar⁸

Affiliations

¹ Department of Medicine, Washington University in St. Louis, St. Louis.
² Department of Medicine, Lincoln Medical Center/Weil Cornell Medicine.
³ Department of Medicine, University of Missouri-Columbia, Columbia, MO.
⁴ Department of Cardiovascular Medicine, University of Minnesota, Minneapolis, MN.
⁵ Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx.
⁶ Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA.
⁷ Department of Medicine, Mountainview Regional Medical Center, Las Cruces, NM.
⁸ Division of Gastroenterology, Department of Medicine, NYU Langone Health, Mineola, NY.

PMID: 37994146
DOI: 10.1097/MCG.0000000000001932

Abstract

Goals: To investigate the outcomes of hospitalized patients with gastric antral vascular ectasia (GAVE) in the setting of aortic stenosis (AS).

Background: Although AS is associated with gastrointestinal arteriovenous malformations, its association with GAVE, a rare cause of upper gastrointestinal bleeding, remains unknown.

Study: The National Inpatient Sample database from the years 2016 to 2019 was searched for patients admitted with a diagnosis of GAVE, with and without a history of AS. Univariate and multivariate logistic regression analysis was performed to determine the risk of mortality and in-hospital complications in the GAVE/AS group compared with the GAVE-only group.

Results: Patients with AS had a 2-fold increase in the risk of GAVE [odds ratio (OR): 2.08, P < 0.001], with no statistically significant difference in inpatient mortality between the study groups (OR: 1.36, P = 0.268). Patients with GAVE-AS had a higher risk of hypovolemic shock (OR: 2.00, P = 0.001) and acute coronary syndromes (OR: 2.25, P < 0.001) with no difference in risk of cardiogenic shock (P = 0.695), acute kidney injury (P = 0.550), blood transfusion (P = 0.270), sepsis (P = 0.598), respiratory failure (P = 0.200), or in-hospital cardiac arrest (P = 0.638). The cost of care in patients with GAVE-AS was increased by a mean of $4729 (P = 0.022), with no increase in length of stay (P = 0.320) when compared with patients with GAVE-only.

Conclusions: Patients with AS have a 2-fold increase in the risk of development of GAVE. Patients with AS admitted for GAVE-related bleeding are at higher rates of hypovolemic shock, acute coronary syndrome, and higher resource utilization when compared with admitted patients with GAVE without AS.