Post-polypectomy bleeding and thromboembolism risks associated with warfarin vs direct oral anticoagulants
| العنوان: | Post-polypectomy bleeding and thromboembolism risks associated with warfarin vs direct oral anticoagulants |
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| المؤلفون: | Takuro Shimbo, Tatsuhiro Iida, Kazuhiro Watanabe, Sakurako Kobayashi, Naomi Uemura, Mariko Hamada, Naoyoshi Nagata, Junichi Akiyama, Naohiro Yanagisawa |
| المصدر: | World Journal of Gastroenterology |
| بيانات النشر: | Baishideng Publishing Group Inc, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, medicine.medical_treatment, Administration, Oral, Colonic Polyps, High-risk endoscopic procedures, 030204 cardiovascular system & hematology, Postoperative Hemorrhage, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Japan, Retrospective Study, Thromboembolism, Medicine, Humans, heterocyclic compounds, cardiovascular diseases, Post-procedure gastrointestinal bleeding, Aged, Retrospective Studies, business.industry, Heparin, Gastroenterology, Warfarin, Anticoagulants, General Medicine, Colonoscopy, Polypectomy, Surgery, stomatognathic diseases, Practice Guidelines as Topic, 030211 gastroenterology & hepatology, Female, business, Endoscopic guideline validation, medicine.drug, Novel oral anticoagulants |
| الوصف: | AIM To verify the validity of the endoscopy guidelines for patients taking warfarin or direct oral anticoagulants (DOAC). METHODS We collected data from 218 patients receiving oral anticoagulants (73 DOAC users, 145 warfarin users) and 218 patients not receiving any antithrombotics (age- and sex-matched controls) who underwent polypectomy. (1) We evaluated post-polypectomy bleeding (PPB) risk in patients receiving warfarin or DOAC compared with controls; (2) we assessed the risks of PPB and thromboembolism between three AC management methods: Discontinuing AC with heparin bridge (HPB) (endoscopy guideline recommendation), continuing AC, and discontinuing AC without HPB. RESULTS PPB rate was significantly higher in warfarin users and DOAC users compared with controls (13.7% and 13.7% vs 0.9%, P < 0.001), but was not significantly different between rivaroxaban (13.2%), dabigatran (11.1%), and apixaban (13.3%) users. Two thromboembolic events occurred in warfarin users, but none in DOAC users. Compared with the continuing anticoagulant group, the discontinuing anticoagulant with HPB group (guideline recommendation) had a higher PPB rate (10.8% vs 19.6%, P = 0.087). These findings were significantly evident in warfarin but not DOAC users. One thrombotic event occurred in the discontinuing anticoagulant with HPB group and the discontinuing anticoagulant without HPB group; none occurred in the continuing anticoagulant group. CONCLUSION PPB risk was similar between patients taking warfarin and DOAC. Thromboembolism was observed in warfarin users only. The guideline recommendations for HPB should be re-considered. |
| اللغة: | English |
| تدمد: | 2219-2840 1007-9327 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8ed41dbdca1d7bd3f2bb76acce0efd53 http://europepmc.org/articles/PMC5897858 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....8ed41dbdca1d7bd3f2bb76acce0efd53 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 22192840 10079327 |
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