Risk of acute myocardial infarction and stroke after discharge from in-hospital care due to complicated and uncomplicated peptic ulcer disease

Background: The incidence of acute cardiovascular and cerebrovascular events in patients treated for complicated or uncomplicated peptic ulcer disease (PUD) has not been ascertained completely. METHOD: All patients with in-hospital treatment due to PUD between 1987 and 2007, who did not have any past history of acute or chronic cardiovascular or cerebrovascular disease, were identified through the Swedish Patient Register. Standardized incidence ratios were calculated to compare the subsequent incidence of acute myocardial infarction (AMI), ischemic, or hemorrhagic stroke after hospital admission in six different subgroups of PUD relative to the general population. To partly account for the impact of smoking, the incidence of lung cancer in those treated for PUD was compared with that of the general population. Results: A total of 84 156 patients with no past history of acute or chronic cardiovascular or cerebrovascular disease were discharged from hospital due to PUD. The risk of AMI, ischemic, or hemorrhagic stroke was increased from 2-fold to 4-fold within the first 60 days of hospitalization due to PUD compared with the general population. This risk remained 30-70% higher among all subgroups of PUD compared with the general population throughout the entire follow-up period. Conclusion: Patients treated in hospital for PUD have a higher risk of AMI and stroke compared with the general population. Careful surveillance of these patients seems to be indicated, particularly during the first 60 days after discharge.