Thienopyridine derivatives as risk factors for bleeding following high risk endoscopic treatments: Safe Treatment on Antiplatelets (STRAP) study

Abstract

UMIN000009176.

Risk factors for bleeding after gastric endoscopic submucosal dissection: a systematic review and meta-analysis

“…On the other hand, thienopyridines were associated with higher PPB risk even with discontinuation for 5 to 8 days before and resumption at a median of 3 days after ESD. 12 Heparin replacement was not identified as a significant risk factor in 1 study, 43 although an opposite result was found in another study. 40 Gastroprotective agents were associated with lower PPB in patients undergoing AT in 1 study.…”

“…PPB rates ranged from .6% 11 to 26.9%, 12 and the pooled PPB rate was 5.1% (95% CI, 4.5%-5.7%), with significant heterogeneity across studies (I 2 Z 84.46, P < .001). However, PPB rates were not significantly different according to study design (5.9% in RCTs, 6.1% in prospective studies, and 4.9% in retrospective studies; I 2 > 80%).…”

Continued use of low-dose aspirin may increase risk of bleeding after gastrointestinal endoscopic submucosal dissection: A meta-analysis

“…Takeuchi found that combining LDA with warfarin and longer ESD operations increased the rate of post-ESD bleeding (27). Moreover, Satoshi showed that taking thienopyridine derivatives with aspirin increased the hazard of bleeding after ESD, particularly in gastric ESD (34). These issues warrant further studies.…”

Updated evidence on endoscopic resection of early gastric cancer from Japan

“…Four studies regarding short-term and/or long-term outcomes in specific or general ESD patients were identified [31][32][33][34]. As the short-term outcomes in patients at high risk of thromboembolism who were regularly taking antiplatelet agents, Ono et al [31] reported a 26 % post-ESD ulcer bleeding rate, which led to early termination of the prospective cohort study.…”