Hypercoagulability in acute bleeding peptic ulcer disease assessed by thrombin-antithrombin III concentrations.

OBJECTIVE

To find out whether patients with acute bleeding peptic ulcers have hypercoagulable blood.

DESIGN

Prospective open study.

SETTING

District hospital in Sweden.

SUBJECTS

54 consecutive patients with duodenal ulcer (n = 25) and gastric ulcer (n = 29) admitted with haematemesis or melaena, or both.

INTERVENTIONS

Diagnosis verified on admission by endoscopy, and healing was examined at follow up. Consumption of non-steroidal anti-inflammatory drugs, and smoking habits, were recorded.

MAIN OUTCOME MEASURES

Coagulation of the blood monitored by concentrations of plasma thrombin-antithrombin III (TAT) complex in samples obtained on admission for the acute bleeding episode and at follow up 1-2 months later.

RESULTS

The plasma TAT complex concentrations were raised during the acute bleeding episode (p < 0.001) compared with an age matched reference group. The TAT complex concentrations measured at follow up had returned to the reference range in all patients, whether or not their ulcers had healed.

CONCLUSION

The results indicate that patients with acute haemorrhage from peptic ulcers have hypercoagulable blood during the acute episode.