Safety and Efficacy of the Noncessation Method of Antithrombotic Agents after Emergency Endoscopic Hemostasis in Patients with Nonvariceal Upper Gastrointestinal Bleeding: A Multicenter Pilot Study

Autor: Daisuke Yamaguchi, Naoyuki Tominaga, Koichi Miyahara, Nanae Tsuruoka, Yasuhisa Sakata, Yuki Takeuchi, Takuya Matsunaga, Hidenori Hidaka, Takashi Akutagawa, Takahiro Noda, Shinichi Ogata, Seiji Tsunada, Motohiro Esaki
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Canadian Journal of Gastroenterology and Hepatology, Vol 2021 (2021)
Druh dokumentu: article
ISSN: 2291-2789
2291-2797
DOI: 10.1155/2021/6672440
Popis: Background and Aims. The present study aimed to clarify the safety and efficacy of the noncessation method of antithrombotic agents after emergency endoscopic hemostasis in patients with nonvariceal upper gastrointestinal bleeding (UGIB). Methods. In this multicenter, prospective, pilot study, we performed emergency endoscopic hemostasis for nonvariceal UGIB in patients taking antithrombotic agents and resumed the medications without a cessation period (group A). The clinical characteristics, types of antithrombotic agents, UGIB etiology, treatment outcome, and adverse events were evaluated. We used propensity score matching to compare treatment outcomes and adverse events with our previous cohort (group B) in whom antithrombotic agents were transiently discontinued after emergency endoscopic hemostasis. Results. Forty-three consecutive patients were prospectively enrolled. The main antithrombotic agents were low-dose aspirin and direct oral anticoagulants; 11 patients (25.6%) were taking multiple antithrombotics. Peptic ulcers were the main cause of bleeding (95.4%). Endoscopic hemostasis was successful in all patients and the incidence of rebleeding within a month was 7.0%. Propensity score matching created 40 matched pairs. Endoscopic hemostasis was performed by soft coagulation significantly more frequently in group A than in group B (97.5% versus 60.0%, P
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