Questionnaire-Based Survey on Gastrointestinal Bleeding and Management of Antithrombotic Agents during Endoscopy Among Asian Countries

Digestion. 2018;97(1):97-106. doi: 10.1159/000484228. Epub 2018 Feb 2.

Abstract

Objective: Guidelines on the management of antithrombotic therapy for endoscopic procedures vary among countries. Differences in the management of antithrombotic agents for endoscopic procedures between Western and Eastern countries have already been reported. However, no study has investigated the differences among Asian countries. The aim of this study was to examine the differences in the etiology of gastrointestinal bleeding and management of antithrombotic agents during endoscopic procedures between Japan and other Asian countries (OAC).

Methods: Questionnaires regarding gastrointestinal bleeding in clinical practice and management of antithrombotic agents during endoscopy were distributed to members of the International Gastroenterology Consensus Symposium Study Group. We analyzed the questionnaire answers and compared the results between Japan and OAC.

Results: The cause of and treatment methods for gastrointestinal bleeding differed between Japan and OAC. In Japan, the trend was to continue drugs at the time of biopsy and endoscopic therapy. Even in cases of discontinuation, the drug withdrawal period was as short as <3 days. Thrombotic complications caused by the withdrawal of antithrombotic agents were observed more frequently in Japan (34.78%) than in OAC (22.46%; p = 0.016).

Conclusion: Due to differences in guidelines and complications associated with discontinuation of drugs, the antithrombotic withdrawal period in Japan tended to be shorter than that in OAC.

Keywords: Anticoagulants; Antiplatelet agents; Asia; Gastrointestinal bleeding; Thromboembolism.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Asia
  • Biopsy / adverse effects
  • Biopsy / methods
  • Consensus Development Conferences as Topic
  • Endoscopy, Gastrointestinal / adverse effects*
  • Endoscopy, Gastrointestinal / methods
  • Endoscopy, Gastrointestinal / standards
  • Female
  • Fibrinolytic Agents / adverse effects*
  • Fibrinolytic Agents / standards
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / prevention & control*
  • Humans
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Surveys and Questionnaires
  • Thrombosis / epidemiology*
  • Thrombosis / etiology
  • Thrombosis / prevention & control
  • Withholding Treatment / standards*

Substances

  • Fibrinolytic Agents