Department of Internal Medicine, Saga Medical School, Saga, Japan.
Department of Medical Innovation, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan.
Digestion. 2018;97(1):97-106. doi: 10.1159/000484228. Epub 2018 Feb 2.
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).
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.
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).
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.
不同国家的内镜操作抗栓治疗管理指南存在差异。已报道西方国家和东方国家之间内镜操作中抗栓药物管理的差异,但尚无研究调查亚洲国家之间的差异。本研究旨在探讨日本与其他亚洲国家(OAC)内镜操作中胃肠道出血病因和抗栓药物管理的差异。
向国际胃肠共识研讨会研究组的成员分发了关于临床实践中胃肠道出血和内镜检查期间抗栓药物管理的调查问卷。我们分析了问卷答案,并比较了日本和 OAC 之间的结果。
日本和 OAC 之间胃肠道出血的病因和治疗方法存在差异。在日本,在进行活检和内镜治疗时,倾向于继续使用药物。即使停药,停药期也短于<3 天。与 OAC(22.46%;p=0.016)相比,日本更频繁地观察到抗栓药物停药引起的血栓并发症(34.78%)。
由于指南和停药相关并发症的差异,日本的抗栓停药期比 OAC 倾向于更短。