Endoscopy 2021; 53(S 01): S5
DOI: 10.1055/s-0041-1724261
Abstracts | ESGE Days
ESGE Days 2021 Oral presentations
Thursday, 25 March 2021 10:00 – 10:45 Plenary with best abstracts Room 1

Thromboembolic Events and Endoscopy-Related Bleeding in Patients on Direct Oral Anticoagulants or Vitamin K Antagonists: A Multicentric Prospective Observational Study

E Rodriguez de Santiago
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
,
R Sánchez Aldehuelo
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
,
F Riu Pons
2   Hospital del Mar, Department of Gastroenterology, Endoscopy Unit, Barcelona, Spain
,
C Rodríguez Escaja
3   Hospital Universitario Central de Asturias, Servicio de Aparato Digestivo, Oviedo, Spain
,
G Fernández Esparrach
4   University of Barcelona, Endoscopy Unit, Gastroenterology Department, ICMDiM, Hospital Clinic, Barcelona, Spain
,
Á Cañete Ruiz
5   12 de Octubre University Hospital, Endoscopy Unit, Gastroenterology Department, Madrid, Spain
,
C Ferre Aracil
6   Hospital Universitario Puerta de Hierro, Gastroenterology Department, Research Institute Segovia Arana, Madrid, Spain
,
D Pérez Corte
7   Hospital de Avilés, Department of Gastroenterology, Avilés, Spain
,
R Ríos León
8   Hospital General de Villalba, Servicio de Aparato Digestivo, Madrid, Spain
,
HM Marcos Prieto
9   Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Servicio de Aparato Digestivo, Salamanca, Spain
,
PG Delgado Guillena
10   Hospital General de Granollers, Department of Gastroenterology, Barcelona, Spain
,
A García Rodríguez
11   Hospital de Viladecans, Department of Digestive Diseases, Barcelona, Spain
,
C Warner Argente
12   Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain
,
A Muriel
13   Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBERESP, Madrid, Spain
,
E De La Fuente Briongos
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
,
A García García de Paredes
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
,
S Parejo Carbonell
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
,
L Téllez
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
,
C Senosiain Lalastra
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
,
D Burgos Santamaría
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
,
M Aicart Ramos
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
,
B Mateos Muñoz
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
,
B Peñas García
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
,
G Pagano
2   Hospital del Mar, Department of Gastroenterology, Endoscopy Unit, Barcelona, Spain
,
G Casals Urquiza
2   Hospital del Mar, Department of Gastroenterology, Endoscopy Unit, Barcelona, Spain
,
M Urpi Ferreruela
2   Hospital del Mar, Department of Gastroenterology, Endoscopy Unit, Barcelona, Spain
,
MA de Jorge Turrión
3   Hospital Universitario Central de Asturias, Servicio de Aparato Digestivo, Oviedo, Spain
,
E Barreiro Alonso
3   Hospital Universitario Central de Asturias, Servicio de Aparato Digestivo, Oviedo, Spain
,
M Fraile López
3   Hospital Universitario Central de Asturias, Servicio de Aparato Digestivo, Oviedo, Spain
,
A Gómez Outomuro
3   Hospital Universitario Central de Asturias, Servicio de Aparato Digestivo, Oviedo, Spain
,
MI Altamirano
4   University of Barcelona, Endoscopy Unit, Gastroenterology Department, ICMDiM, Hospital Clinic, Barcelona, Spain
,
M Núñez Esteban
4   University of Barcelona, Endoscopy Unit, Gastroenterology Department, ICMDiM, Hospital Clinic, Barcelona, Spain
,
M Ruiz Andreu
4   University of Barcelona, Endoscopy Unit, Gastroenterology Department, ICMDiM, Hospital Clinic, Barcelona, Spain
,
J Arribas Anta
5   12 de Octubre University Hospital, Endoscopy Unit, Gastroenterology Department, Madrid, Spain
,
D de Frutos
6   Hospital Universitario Puerta de Hierro, Gastroenterology Department, Research Institute Segovia Arana, Madrid, Spain
,
A Herreros de Tejada
6   Hospital Universitario Puerta de Hierro, Gastroenterology Department, Research Institute Segovia Arana, Madrid, Spain
,
ML Arias Rivera
8   Hospital General de Villalba, Servicio de Aparato Digestivo, Madrid, Spain
,
M Roldán Fernández
9   Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Servicio de Aparato Digestivo, Salamanca, Spain
,
ÁF Marcos Martin
9   Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Servicio de Aparato Digestivo, Salamanca, Spain
,
J Zamora
13   Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBERESP, Madrid, Spain
,
A Brujats
14   Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Department of Gastroenterology, Barcelona, Spain
,
E Tavío
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
,
P Pérez Riveras
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
,
E Vázquez Sequeiros
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
,
A Albillos
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
,
SEED-AEG ENDOHEM Study Group › Author Affiliations
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    Aims 1. To compare the risks of endoscopy-related gastrointestinal bleeding and thromboembolic events in patients on direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs) in elective endoscopy.

    2. To examine the impact of the timing of anticoagulant resumption on the risk of delayed bleeding in high-risk therapeutic procedures.

    Methods We conducted a multicenter, prospective, observational study from January 2018 to March 2020 of patients on oral anticoagulants undergoing elective endoscopic procedures. Our primary outcomes were 90-day thromboembolic events and 30-day endoscopy-related gastrointestinal bleeding. The inverse probability of treatment weighting propensity score method was used for baseline covariate adjustment.

    Results A total of 1,602 patients on oral anticoagulants (1,004 on VKAs and 598 on DOACs) underwent 1,874 elective endoscopic procedures The 2 groups had similar risks of endoscopy-related gastrointestinal bleeding (VKAs vs DOACs, 6.2 % vs 6.7 %; adjusted odds ratio [OR], 1.05; 95 % CI, 0.67–1.65) and thromboembolic events (VKAs vs DOACs, 1.3 % vs 1.5 %; adjusted OR, 0.90; 95 % CI, 0.34–2.38). Mortality was higher from thromboembolic events than from bleeding events (9.1 % vs 0 %, P = .03). In high bleeding risk procedures (n = 747), delayed anticoagulant resumption (> 48 hours or 24–48 hours vs < 24 hours) did not reduce the risk of postprocedural bleeding (10.3 %, 9 %, and 5.8 %, respectively; adjusted P = .43). Hot and cold snare polypectomy were the most frequent high-risk interventions (41.8 % and 39.8 %, respectively).

    Conclusions In a prospective study of patients on DOACs or VKAs undergoing elective endoscopy, endoscopy-related bleeding and thromboembolic events showed similar risk. Our study suggests that early anticoagulant resumption is safe in most patients, but more data are needed for advanced high-risk therapeutic procedures.

    Citation: Rodriguez de Santiago E, Sánchez Aldehuelo R, Riu Pons F et al. OP1 THROMBOEMBOLIC EVENTS AND ENDOSCOPY-RELATED BLEEDING IN PATIENTS ON DIRECT ORAL ANTICOAGULANTS OR VITAMIN K ANTAGONISTS: A MULTICENTRIC PROSPECTIVE OBSERVATIONAL STUDY. Endoscopy 2021; 53: S5.


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    Publication History

    Article published online:
    19 March 2021

    © 2021. European Society of Gastrointestinal Endoscopy. All rights reserved.

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