title: Characteristics of patients with non-variceal upper gastrointestinal bleeding taking antithrombotic agents.
abstract: OBJECTIVE
  The present study aimed to clarify the features and management of non-variceal upper gastrointestinal bleeding (UGIB) in Japanese patients taking antithrombotic agents.
  
  
  METHODS
  We retrospectively investigated the medical records of 560 patients who underwent emergency endoscopy for UGIB from 2002 to 2013. The patients were divided into two groups: group A, antithrombotic agent use; and group NA, no antithrombotic agent use. We compared clinical characteristics, comorbidities, and causes of UGIB between the groups. We also investigated management with antithrombotics.
  
  
  RESULTS
  Of 560 patients with UGIB, 27.5% were taking antithrombotics, and this proportion gradually increased during the study period. Mean hemoglobin levels on admission were significantly lower in group A (8.0 ± 1.7 g/dL) than in group NA (8.9 ± 2.9 g/dL) (P < 0.001). Patients in group A developed more gastric ulcers and multiple ulcers than did patients in group NA. Incidence of Forrest Ia-type bleeding was lower in group A than in group NA (P < 0.001), and the rate of endoscopic hemostasis was significantly higher in group A (98.7%) than in group NA (94.3%) (P = 0.022). After the release of the 2012 Japan Gastroenterological Endoscopy Society guidelines, the antithrombotic agent cessation periods were significantly shortened (P < 0.001).
  
  
  CONCLUSIONS
  Among patients with UGIB, those taking antithrombotics exhibited more severe clinical signs. However spurting hemorrhage was rare. Antithrombotics may be resumed early after endoscopic hemostasis.
authors.affiliation: Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Saga, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yamaguchi
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Sakata
authors.forename: Nanae
authors.initials: N
authors.lastname: Tsuruoka
authors.forename: Ryo
authors.initials: R
authors.lastname: Shimoda
authors.forename: Toru
authors.initials: T
authors.lastname: Higuchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakata
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Iwakiri
mesh_terms: D000368:Aged; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004932:Esophageal and Gastric Varices; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013927:Thrombosis / Q000517:prevention & control; D041742:Upper Gastrointestinal Tract / Q000187:drug effects*
chemical_list: D005343:Fibrinolytic Agents
keywords: anticoagulant; antiplatelet; antithrombotic; thromboembolism; upper gastrointestinal bleeding