Journal List > Korean J Gastroenterol > v.71(5) > 1094739

Kim and Kim: Management of Patients on Antithrombotic Agents Undergoing Endoscopy

Abstract

Antithrombotic agents are used increasingly in Asia. The management of patients on antithrombotics undergoing elective or emergency endoscopy has become an increasing clinical challenge for gastroenterologists. Current practice guidelines have been developed by societies from western countries. On the other hand, these guidelines cannot meet the specific needs of the Asian Pacific region, raising the need for separate guidelines in Asia. This review compares the recommendations of previous guidelines with the most recently published Asian guidelines regarding the management of patients on antithrombotic agents undergoing elective and emergency endoscopy.

References

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Table 1.
Management of Antithrombotics in Patients with Non-variceal Upper GI Bleeding2,3,5
  APAGE-APSDE ASGE ESGE
DAPT Continue aspirin withhold other antiplatelet up to 5 days after hemostasis Consult cardiologist Continue aspirin consult cardiologist for resumption of other antiplatelet
Warfarin Resume by day 3 if hemostasis is achieved Not mentioned Resume between 7 and 15 days after bleeding event
  Consider heparin bridge therapy in high thrombotic risk patients    
DOACs Resume by day 3 if hemostasis is achieved Not mentioned Not mentioned
  Heparin bridge therapy is not required    

APAGE, Asian Pacific Association of Gastroenterology; APSDE, Asian Pacific Society for Digestive Endoscopy; ASGE, American Society of Gastrointestinal Endoscopy; ESGE, European Society of Gastrointestinal Endoscopy; DAPT, dual antiplatelet therapy; DOACs, direct oral anticoagulants.

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