Review for 10.1186/s12876-022-02611-4 (2022)

Reviewer’s report
Title: 
Survival Outcomes of Patients with Concomitant Acute Variceal Bleeding
and Acute Coronary Syndrome, and the role of antiplatelet agents; An
Institutional Experience from a Lower Middle-Income Country.
Version: 
0 
Date: 
12 Sep 2022
Reviewer's report:
The authors concluded that acute variceal bleeding (AVB) and acute coronary
syndrome (ACS) are severe with high mortality rates. They also concluded that
further bleeding or cardiovascular event after the index event is not frequent.
1. The case number is very limited, with 29 cases. There was no control group to
compare. It is hard to understand that the mortality and morbidity of AVB with
ACS are higher than AVB without ASC.
2. The ASC is heterogenous with a wide range of mortality rates according to
risk stratification. The AVB is also heterogeneous. From 2002 to 2017, the
treatment of ACS and AVB evolved a lot during the study period. It is hard to
conclude the mortality over this period. 
3. Regarding the cirrhotic status and treatment of viral hepatitis, the authors also
cannot prevent these confounding effects on the results of short-term
complications. 
4. There are some grammar and spelling problems. 
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
No
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from apparent manipulation?
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