Document Detail

Cardiac sources of embolism should be routinely screened in ischemic colitis.
MedLine Citation:
PMID:  12873580     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Potential cardiac sources of embolism may promote ischemic colitis. The aim of this study was to evaluate their role in segmental, nongangrenous ischemic colitis and to determine the usefulness of routine cardiac evaluation in patients with this disease. METHODS: Sixty case and 60 control patients matched for age and gender were included and questioned regarding treatment and prior cardiovascular history or risk factors. Potential cardiac sources of embolism, classified as "proven" or " still debated," were screened using an electrocardiogram, rhythmic Holter monitoring over 24 h, and transthoracic echocardiography. RESULTS: Sex ratio (male:female) was 1:2, and mean age was 70 +/- 14 yr. Case and control patients had similar drug use, prior cardiovascular history, and risk factors. A potential cardiac source of embolism was found in 26/60 case (43%), compared with 14/60 control patients (23%) (p = 0.02; OR = 2.5, 95% CI = 1.2-5.5). Excluding the "still debated," 21/60 case (35%), compared with 8/60 control patients (13%), had a "proven" cardiac source of embolism (p < 0.01; OR = 3.5, 95% CI = 1.4-8.4). Electrocardiogram alone misdiagnosed 72% of the "proven" cardiac sources of embolism, whereas the combination electrocardiogram plus Holter monitoring detected 71%, and electrocardiogram plus echocardiography 62%. Twelve of 21 case patients with at least one proven cardiac source of embolism, were previously unknown. Anticoagulant therapy was required in 32% of case patients and antiarrhythmic therapy in 25% of cases. CONCLUSIONS: Potential cardiac sources of embolism were more common in patients with segmental, nongangrenous ischemic colitis than in control patients. Therefore, these patients should undergo a routine electrocardiogram, rhythmic Holter monitoring, and transthoracic echocardiography. Anticoagulant therapy should also be considered for this patient population.
Isabelle Hourmand-Ollivier; Mickael Bouin; Eric Saloux; Remi Morello; Pierre Rousselot; Marie-Astrid Piquet; Thong Dao; Jean-Claude Verwaerde
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  98     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-22     Completed Date:  2003-09-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1573-7     Citation Subset:  IM    
Services d'Hépatogastroentérologie et de Nutrition, Centre Hospitalier Universitaire Côte de Nacre, Caen, France.
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MeSH Terms
Aged, 80 and over
Anticoagulants / therapeutic use
Case-Control Studies
Colitis, Ischemic / etiology*
Coronary Vessels*
Diagnostic Errors
Electrocardiography, Ambulatory
Embolism / complications*,  diagnosis*,  drug therapy,  epidemiology
Middle Aged
Prospective Studies
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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