Impact of direct-acting oral anticoagulants and warfarin on postendoscopic GI bleeding and thromboembolic events in patients undergoing elective endoscopy.

Abstract:

BACKGROUND AND AIMS:An increasing number of patients are undergoing GI endoscopic procedures with active prescriptions for direct oral anticoagulants (DOACs). DOACs have been associated with a higher risk of GI bleeding (GIB) compared with warfarin. Our aims were to compare the risk of postendoscopic GIB and thromboembolic (TE) events among patients on DOACs versus warfarin. METHODS:We conducted a retrospective cohort study of patients aged 18 years or older in a large integrated health care system in Southern California, who had undergone an outpatient GI endoscopic procedure and were taking a DOAC or warfarin between January 1, 2013, and October 1, 2019. We compared bleeding and thrombosis risk in the 30 days after the endoscopic procedure between the warfarin and DOAC groups using multivariate logistic regression analysis adjusted for covariates. RESULTS:Between January 1, 2013, and October 1, 2019, we identified 6765 outpatient GI endoscopic procedures in which patients received preprocedure prescriptions for either a DOAC (1587) or warfarin (5178). Overall, there was no significant difference in postprocedure GIB (odds ratio [OR], 1.165; 95% confidence interval [CI], 0.88-1.55; P = .291) or TE (OR, 0.929; 95% CI, 0.64-1.35; P = .703) between the DOAC and warfarin groups). Subgroup analysis revealed a higher risk of GIB associated with DOAC specifically with EGD procedures (OR, 1.8; 95% CI, 1.15-2.83; P = .011). CONCLUSIONS:There was no significant difference in the overall postendoscopic risk of GIB and TE events among patients with preprocedure use of DOACs compared with patients on warfarin. There may be a higher risk of GIB in patients taking DOACs and undergoing EGD.

journal_name

Gastrointest Endosc

authors

Tien A,Kwok K,Dong E,Wu B,Chung J,Chang J,Reynolds K

doi

10.1016/j.gie.2020.02.038

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

284-292.e2

issue

2

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(20)30214-5

journal_volume

92

pub_type

杂志文章
  • Gastroesophageal endoscopic signs of cirrhosis: independent diagnostic accuracy, interassociation, and relationship to etiology and hepatic dysfunction.

    abstract:BACKGROUND:The main objective of this prospective study was to evaluate the independent diagnostic accuracy of gastroesophageal endoscopic signs for cirrhosis. METHODS:Endoscopic signs were evaluated in vivo by one observer and on standardized videotape recordings by a consensus opinion of two endoscopists, with the s...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/s0016-5107(98)70156-7

    authors: Oberti F,Burtin P,Maïga M,Valsesia E,Pilette C,Calès P

    更新日期:1998-08-01 00:00:00

  • Endoscopic string clip suturing method: a prospective pilot study (with video).

    abstract:BACKGROUND AND AIMS:We developed a suturing method with string and clips for a single-channel endoscope. The feasibility of the string clip suturing method is evaluated in this prospective pilot study. METHODS:This study involved 10 consecutive patients who underwent endoscopic submucosal dissection (ESD) for a duoden...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/j.gie.2017.11.007

    authors: Nishizawa T,Akimoto T,Uraoka T,Mitsunaga Y,Maehata T,Ochiai Y,Fujimoto A,Goto O,Kanai T,Yahagi N

    更新日期:2018-04-01 00:00:00

  • Significance of small distal adenoma for detection of proximal neoplasms in the colorectum.

    abstract:BACKGROUND:The significance of the small distal tubular adenoma detected by sigmoidoscopy as a predictor of proximal neoplasm remains controversial. The aim of this study was to examine the prevalence of proximal neoplasms in patients with and without distal neoplasms. METHODS:This is a retrospective study of 3131 asy...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1067/mge.2000.107908

    authors: Ikeda Y,Mori M,Miyazaki M,Yoshizumi T,Maehara Y,Sugimachi K

    更新日期:2000-09-01 00:00:00

  • Optimal injection volume of epinephrine for endoscopic prevention of recurrent peptic ulcer bleeding.

    abstract:BACKGROUND:Although the initial rate of hemostasis achieved by endoscopic epinephrine injection for peptic ulcer bleeding is high, bleeding recurs in 14.6% to 35.5% of patients. The aim of this study was to compare rates of recurrent bleeding after endoscopic injection of two different volumes of epinephrine in patient...

    journal_title:Gastrointestinal endoscopy

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0016-5107(04)02279-5

    authors: Park CH,Lee SJ,Park JH,Park JH,Lee WS,Joo YE,Kim HS,Choi SK,Rew JS,Kim SJ

    更新日期:2004-12-01 00:00:00

  • Use of detachable snares and elastic bands for endoscopic control of bleeding from large gastric varices.

    abstract:BACKGROUND:Bleeding from gastric varices larger than 2 cm in diameter represents a major limitation for endoscopic hemostasis. METHODS:Endoscopic ligation of gastric varices was performed with detachable snares and elastic bands in 41 patients who had recent bleeding from gastric varices larger than 2 cm in diameter. ...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1067/mge.2002.125104

    authors: Lee MS,Cho JY,Cheon YK,Ryu CB,Moon JH,Cho YD,Kim JO,Kim YS,Lee JS,Shim CS

    更新日期:2002-07-01 00:00:00

  • Does intrabiliary pressure predict basal sphincter of Oddi pressure? A study in patients with and without gallbladders.

    abstract:BACKGROUND:The endoscopic measurement of sphincter of Oddi pressure is a technically difficult procedure requiring significant expertise. Intrabiliary pressure is technically easy to measure. Furthermore, since it is believed that the pathogenesis of pain in patients with sphincter of Oddi dysfunction is attributable t...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/s0016-5107(96)70054-8

    authors: Kalloo AN,Tietjen TG,Pasricha PJ

    更新日期:1996-12-01 00:00:00

  • Treatment of complications of hepatic hydatid disease by ERCP.

    abstract:BACKGROUND:The aim of this study was to evaluate the effectiveness of endoscopic sphincterotomy for preoperative and postoperative complications of hepatic hydatid disease. METHODS:Nineteen patients underwent endoscopic treatment for complications of hepatic hydatid disease. Indications for ERCP in 5 patients treated ...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1067/mge.2001.118256

    authors: Giouleme O,Nikolaidis N,Zezos P,Budas K,Katsinelos P,Vasiliadis T,Eugenidis N

    更新日期:2001-10-01 00:00:00

  • Efficacy and safety of 1-step transnasal endoscopic nasobiliary drainage for the treatment of acute cholangitis in patients with previous endoscopic sphincterotomy (with videos).

    abstract:BACKGROUND:Endoscopic nasobiliary drainage (NBD) for the treatment of acute cholangitis is an accepted method. A recently developed ultrathin transnasal videoendoscope is minimally invasive, even for patients who are critically ill. OBJECTIVE:To evaluate the clinical efficacy and safety of 1-step NBD by transnasal vid...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/j.gie.2007.11.050

    authors: Itoi T,Kawai T,Sofuni A,Itokawa F,Tsuchiya T,Kurihara T,Kusano C,Saito Y,Gotoda T

    更新日期:2008-07-01 00:00:00

  • Capsule endoscopy in nonresponsive celiac disease.

    abstract:BACKGROUND:Nonresponsive celiac disease (CD) is defined by persistent or recurrent symptoms, common after treatment with a gluten-free diet (GFD). OBJECTIVE:To evaluate the utility of capsule endoscopy (CE) in nonresponsive CD. DESIGN:Case-control study. SETTING:Tertiary-care center. PATIENTS:Forty-two consecutive ...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/j.gie.2011.05.049

    authors: Atlas DS,Rubio-Tapia A,Van Dyke CT,Lahr BD,Murray JA

    更新日期:2011-12-01 00:00:00

  • Prospective randomized trial comparing Tannenbaum Teflon and standard polyethylene stents in distal malignant biliary stenosis.

    abstract:BACKGROUND:Our aim was to compare the clinical efficacy of the Tannenbaum (TB) biliary prostheses, a recently designed Teflon stent without side holes, with the Cotton-Huibregtse (CH) polyethylene stent. METHODS:Fifty-seven patients (26 men, mean age 75.5 years) with unresectable malignant tumors and distal biliary st...

    journal_title:Gastrointestinal endoscopy

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1016/s0016-5107(00)70381-6

    authors: Terruzzi V,Comin U,De Grazia F,Toti GL,Zambelli A,Beretta S,Minoli G

    更新日期:2000-01-01 00:00:00

  • Prospective, randomized, back-to-back trial evaluating the usefulness of i-SCAN in screening colonoscopy.

    abstract:BACKGROUND:The newly developed i-SCAN application can theoretically maximize the effectiveness of colonoscopy. However, the practical usefulness of the i-SCAN application during screening colonoscopy has not been assessed. OBJECTIVE:To assess the efficacy of the i-SCAN application during screening colonoscopy. DESIGN...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.gie.2011.11.040

    authors: Hong SN,Choe WH,Lee JH,Kim SI,Kim JH,Lee TY,Kim JH,Lee SY,Cheon YK,Sung IK,Park HS,Shim CS

    更新日期:2012-05-01 00:00:00

  • Predictors of stricture formation after photodynamic therapy for high-grade dysplasia in Barrett's esophagus.

    abstract:BACKGROUND:Stricture formation is the leading cause of long-term morbidity after photodynamic therapy (PDT). Risk factors for stricture formation have not been studied. OBJECTIVE:To assess risk factors for stricture formation in patients undergoing PDT for Barrett's esophagus with high-grade dysplasia (HGD). DESIGN:R...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/j.gie.2006.04.028

    authors: Prasad GA,Wang KK,Buttar NS,Wongkeesong LM,Lutzke LS,Borkenhagen LS

    更新日期:2007-01-01 00:00:00

  • Histologic results of EMR for esophageal lesions diagnosed as high-grade intraepithelial squamous neoplasia by endoscopic biopsy.

    abstract:BACKGROUND:Biopsy specimens obtained from esophageal lesions detected in endoscopic screening with iodine staining have often been diagnosed as high-grade intraepithelial squamous neoplasia (WHO 2000). However, a management strategy for such lesions has not been established. The purpose of this study was to perform EMR...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/j.gie.2005.09.027

    authors: Shimizu Y,Kato M,Yamamoto J,Ono Y,Katsurada T,Ono S,Mori Y,Nakagawa M,Nakagawa S,Itoh T,Asaka M

    更新日期:2006-01-01 00:00:00

  • Effect of left lateral tilt-down position on cecal intubation time: a 2-center, pragmatic, randomized controlled trial.

    abstract:BACKGROUND AND AIMS:Colonoscopy insertion is technically challenging, time-consuming, and painful, especially for the sigmoid. Several pilot studies indicated that the (left) tilt-down position could facilitate the insertion procedure, but no formal trials have been published to demonstrate its efficacy. We performed t...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1016/j.gie.2017.11.012

    authors: Zhao SB,Yang X,Fang J,Wang SL,Gu L,Xia T,Su XJ,Wang D,Li ZS,Bai Y

    更新日期:2018-03-01 00:00:00

  • Forceful balloon dilation: an outpatient procedure for achalasia.

    abstract::The initial treatment of choice in patients with achalasia is balloon dilation. Heretofore, this procedure was performed on an in-hospital basis resulting in high patient cost. This study evaluated the safety and efficacy of pneumatic dilation as an outpatient procedure. Sixty-one procedures were performed on 50 patie...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/s0016-5107(90)70964-9

    authors: Barkin JS,Guelrud M,Reiner DK,Goldberg RI,Phillips RS

    更新日期:1990-03-01 00:00:00

  • A new synthetic porcine secretin for facilitation of cannulation of the dorsal pancreatic duct at ERCP in patients with pancreas divisum: a multicenter, randomized, double-blind comparative study.

    abstract:BACKGROUND:Secretin, a 27 amino acid polypeptide released in response to duodenal luminal acidification, stimulates secretion of water and bicarbonate from pancreatic ductal cells. To date the only secretin available for clinical use has been a biologically derived compound extracted from porcine duodenums. Although us...

    journal_title:Gastrointestinal endoscopy

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1067/mge.2003.195

    authors: Devereaux BM,Fein S,Purich E,Trout JR,Lehman GA,Fogel EL,Phillips S,Etemad R,Jowell P,Toskes PP,Sherman S

    更新日期:2003-05-01 00:00:00

  • Ballooning of the papilla during contrast injection: the semaphore of a choledochocele.

    abstract:BACKGROUND:Choledochocele is a rare abnormality involving the intramural segment of the common bile duct. ERCP is essential to demonstrate a choledochocele. The aim of this study was to investigate the duodenoscopic and cholangiographic findings during ERCP. METHODS:Over a 4-year period, 17 symptomatic patients (8 men...

    journal_title:Gastrointestinal endoscopy

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0016-5107(98)70187-7

    authors: Kim MH,Myung SJ,Lee SK,Yoo BM,Seo DW,Lee MH,Jung SA,Kim YS,Min YI

    更新日期:1998-09-01 00:00:00

  • Risk factors for post-ERCP pancreatitis in wire-guided cannulation for therapeutic biliary ERCP.

    abstract:BACKGROUND:Wire-guided cannulation (WGC) was reported to decrease post-ERCP pancreatitis (PEP), but risk factors for PEP in WGC are not fully elucidated. OBJECTIVE:To evaluate the incidence and risk factors of PEP in WGC. DESIGN:Single-center retrospective study. SETTING:Academic center. PATIENTS:A total of 800 con...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/j.gie.2014.06.005

    authors: Nakai Y,Isayama H,Sasahira N,Kogure H,Sasaki T,Yamamoto N,Saito K,Umefune G,Akiyama D,Kawahata S,Matsukawa M,Saito T,Hamada T,Takahara N,Mizuno S,Miyabayashi K,Mohri D,Hirano K,Tada M,Koike K

    更新日期:2015-01-01 00:00:00

  • Risk of sedation for upper GI endoscopy exacerbating subclinical hepatic encephalopathy in patients with cirrhosis.

    abstract:BACKGROUND:The risk of exacerbating subclinical hepatic encephalopathy associated with the administration of sedative drugs in patients with cirrhosis undergoing diagnostic upper gastrointestinal (GI) endoscopy for portal hypertension remains to be determined. METHODS:Ten adult patients with cirrhosis completed number...

    journal_title:Gastrointestinal endoscopy

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0016-5107(99)70283-x

    authors: Assy N,Rosser BG,Grahame GR,Minuk GY

    更新日期:1999-06-01 00:00:00

  • Second-generation colon capsule endoscopy compared with colonoscopy.

    abstract:BACKGROUND:Colon capsule endoscopy (CCE) represents a noninvasive technology that allows visualization of the colon without requiring sedation and air insufflation. A second-generation colon capsule endoscopy system (PillCam Colon 2) (CCE-2) was developed to increase sensitivity for colorectal polyp detection compared ...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.gie.2011.03.1125

    authors: Spada C,Hassan C,Munoz-Navas M,Neuhaus H,Deviere J,Fockens P,Coron E,Gay G,Toth E,Riccioni ME,Carretero C,Charton JP,Van Gossum A,Wientjes CA,Sacher-Huvelin S,Delvaux M,Nemeth A,Petruzziello L,de Frias CP,Mayershofe

    更新日期:2011-09-01 00:00:00

  • Laser lithotripsy of difficult biliary stones.

    abstract::From June 1991 to September 1992, 16 patients (mean age, 72 +/- 5 years) were treated with intra-corporeal laser lithotripsy (ICL). Thirteen patients had choledocholithiasis with at least one stone larger than 20 mm; 3 patients had intra-hepatic lithiasis. All other methods, including mechanical lithotripsy, extra-cor...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/s0016-5107(94)70058-3

    authors: Prat F,Fritsch J,Choury AD,Frouge C,Marteau V,Etienne JP

    更新日期:1994-05-01 00:00:00

  • EUS-guided drainage of pancreatic fluid collections using a novel lumen-apposing metal stent on an electrocautery-enhanced delivery system: a large retrospective study (with video).

    abstract:BACKGROUND AND AIMS:A lumen-apposing, self-expanding metal stent incorporated in an electrocautery-enhanced delivery system for EUS-guided drainage of pancreatic fluid collections (PFCs) recently has become available. The aim of this study was to analyze the safety and clinical effectiveness of this newly developed dev...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/j.gie.2015.04.006

    authors: Rinninella E,Kunda R,Dollhopf M,Sanchez-Yague A,Will U,Tarantino I,Gornals Soler J,Ullrich S,Meining A,Esteban JM,Enz T,Vanbiervliet G,Vleggaar F,Attili F,Larghi A

    更新日期:2015-12-01 00:00:00

  • Endoscopic therapy for bile leak based on a new classification: results in 207 patients.

    abstract:BACKGROUND:Bile leak is among the most common complications of cholecystectomy. Endoscopic therapy is empiric; a systematic approach to management of bile leak has not been established. METHODS:The severity of bile leak was classified by endoscopic retrograde cholangiography into low grade (leak identified only after ...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/s0016-5107(04)01892-9

    authors: Sandha GS,Bourke MJ,Haber GB,Kortan PP

    更新日期:2004-10-01 00:00:00

  • Tissue damage of different submucosal injection solutions for EMR.

    abstract:BACKGROUND:When choosing submucosal injection solutions for EMR, tissue damage should be considered, as well as the lesion-lifting ability. The objective of the study was to find out the potential tissue damage of submucosal injection solutions. METHODS:The submucosal injection solutions examined were the following: n...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/j.gie.2005.07.052

    authors: Fujishiro M,Yahagi N,Kashimura K,Matsuura T,Nakamura M,Kakushima N,Kodashima S,Ono S,Kobayashi K,Hashimoto T,Yamamichi N,Tateishi A,Shimizu Y,Oka M,Ichinose M,Omata M

    更新日期:2005-12-01 00:00:00

  • Self-approximating transluminal access technique for natural orifice transluminal endoscopic surgery: a porcine survival study (with video).

    abstract:BACKGROUND:The ability to access the abdominal cavity though a direct (modified-PEG type) gastric incision to perform natural orifice transluminal endoscopic surgery (NOTES) has been demonstrated in the literature. However, the optimal technique to access the abdomen remains unknown. OBJECTIVE:The aim of this study wa...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/j.gie.2007.09.023

    authors: Pauli EM,Moyer MT,Haluck RS,Mathew A

    更新日期:2008-04-01 00:00:00

  • Immunoglobulin G4-related lymphoplasmacytic sclerosing cholangitis that mimics infiltrating hilar cholangiocarcinoma: part of a spectrum of autoimmune pancreatitis?

    abstract:BACKGROUND:Autoimmune pancreatitis has been designated as sclerosing pancreatocholangitis, because this disease shows a high prevalence of bile-duct lesions. We present herein the clinical characteristics of unusual cases that show dominant bile-duct lesions and mimicking infiltrating hilar cholangiocarcinomas. METHOD...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/s0016-5107(05)00561-4

    authors: Hamano H,Kawa S,Uehara T,Ochi Y,Takayama M,Komatsu K,Muraki T,Umino J,Kiyosawa K,Miyagawa S

    更新日期:2005-07-01 00:00:00

  • Comparison of standard forward-viewing mode versus ultrawide-viewing mode of a novel colonoscopy platform: a prospective, multicenter study in the detection of simulated polyps in an in vitro colon model (with video).

    abstract:BACKGROUND:Although colonoscopy is the criterion standard for detecting colorectal adenomas and cancers, a significant percentage of adenomas are missed. OBJECTIVE:To compare forward-viewing with ultrawide-viewing colonoscopy in the detection of simulated colon polyps in an in vitro colon model. DESIGN:Prospective, m...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.gie.2012.12.011

    authors: Gralnek IM,Carr-Locke DL,Segol O,Halpern Z,Siersema PD,Sloyer A,Fenster J,Lewis BS,Santo E,Suissa A,Segev M

    更新日期:2013-03-01 00:00:00

  • The value of wireless capsule endoscopy in patients with complicated celiac disease.

    abstract:BACKGROUND:Celiac disease may be complicated by symptoms that raise the suspicion of small-intestinal malignancy. The objective is to evaluate wireless capsule endoscopy (WCE) in complicated celiac disease. METHODS:This is a prospective study at a university referral center. There were 47 patients. The indications for...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/s0016-5107(05)01566-x

    authors: Culliford A,Daly J,Diamond B,Rubin M,Green PH

    更新日期:2005-07-01 00:00:00

  • Integrated diagnostic strategy for the invasion depth of early gastric cancer by conventional endoscopy and EUS.

    abstract:BACKGROUND:Although conventional endoscopy (CE) and EUS are considered useful for predicting the invasion depth (T-staging) in early gastric cancer (EGC), no effective diagnostic strategy has been established. OBJECTIVE:To produce simple CE criteria and to elucidate an efficient diagnostic method by combining CE and E...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1016/j.gie.2015.01.022

    authors: Tsujii Y,Kato M,Inoue T,Yoshii S,Nagai K,Fujinaga T,Maekawa A,Hayashi Y,Akasaka T,Shinzaki S,Watabe K,Nishida T,Iijima H,Tsujii M,Takehara T

    更新日期:2015-09-01 00:00:00

  • Minute findings by magnifying colonoscopy are useful for the evaluation of ulcerative colitis.

    abstract:BACKGROUND:Colonoscopy has an important role in the diagnosis of ulcerative colitis. However, colonoscopic findings are inadequate for the prediction of relapse without histologic examination. In this study, the role of magnifying colonoscopy in ulcerative colitis was evaluated. METHODS:One hundred sixteen magnifying ...

    journal_title:Gastrointestinal endoscopy

    pub_type: 杂志文章

    doi:10.1067/mge.2002.127101

    authors: Fujiya M,Saitoh Y,Nomura M,Maemoto A,Fujiya K,Watari J,Ashida T,Ayabe T,Obara T,Kohgo Y

    更新日期:2002-10-01 00:00:00