Abstract Body (Do not enter title and authors here): Background: Gastrointestinal (GI) bleeding is a significant complication that can occur during acute myocardial infarction (AMI), worsening the patient's condition and complicating treatment. However, the specific impact of GI bleeding on outcomes in AMI patients remains unclear. This meta-analysis aims to clarify the impact of GI bleeding on key clinical outcomes in these patients.

Methods: A comprehensive literature search was conducted using the PubMed, Embase, and Google Scholar databases. Random effect models were utilized to calculate Mantel-Haenszel odds ratios (ORs) and inverse variance standardized mean differences (SMDs) with 95% confidence intervals (CIs). Statistical significance was set at p < 0.05. The primary endpoints were in-hospital mortality, major adverse cardiovascular events (MACE), stroke episodes, length of hospital stay, and long-term mortality.

Results: Twenty-one articles, comprising approximately 1.7 million patients with AMI, were included in the meta-analysis. GI bleeding in AMI patients was associated with an increased risk of in-hospital mortality (OR = 4.61; 95% CI 2.95 to 7.20; p<0.001), MACE (OR = 2.39; 95% CI 1.04 to 5.51; p<0.001), stroke (OR = 2.71; 95% CI 1.07 to 6.89, p<0.001) and long term mortality (OR = 5.27; 95% CI 3.95 to 7.04; p<0.001) compared with AMI patient without complication of gastrointestinal bleeding. Furthermore, Patients with GI bleeding in AMI also experienced an increased length of hospital stay (SMD = 0.67; 95% CI 0.46 to 0.88; p<0.001).

Conclusion: These findings emphasize the significance of promptly recognizing and managing GI bleeding in the context of AMI to minimize its negative impact on patient outcomes.