Nanae Tsuruoka1, Ryuichi Iwakiri1, Yasuhisa Sakata1, Kazuma Fujimoto1, Takeshi Kamiya2, Takashi Joh3, Kengo Tokunaga4, Shin'ichi Takahashi4, Yoshikazu Kinoshita5, Kazuhiko Uchiyama6, Yuji Naito6, Akihito Nagahara7, Toshio Watanabe8, Francis K L Chan9, Ki-Baik Hahm10, Udom Kachintorn11, Kwong Ming Fock12, Ari Fahrial Syam13, Abdul Aziz Rani13, Jose D Sollano14, Qi Zhu15. 1. Department of Internal Medicine, Saga Medical School, Saga, Japan. 2. Department of Medical Innovation, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan. 3. Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan. 4. The Third Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan. 5. Department of Gastroenterology and Hepatology, Shimane University, Faculty of Medicine, Shimane, Japan. 6. Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan. 7. Department of Gastroenterology, Juntendo University Shizuoka Hospital, Shizuoka, Japan. 8. Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan. 9. Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. 10. Digestive Disease Center, CHA University School of Medicine and CHA University Bundang Medical Center, Seoul, Republic of Korea. 11. Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital Mahidol University, Bangkok, Thailand. 12. Department of Gastroenterology, Changi General Hospital, Singapore, Singapore. 13. Department of Internal Medicine, Faculty of Medicine, University of Indonesia Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 14. University of Santo Tomas, Manilia, Philippines. 15. SinoUnited Health Clinic, Gopher Medical Center, Shanghai, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Abstract
OBJECTIVE: 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). METHODS: 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. RESULTS: 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). CONCLUSION: 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.
OBJECTIVE: 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). METHODS: 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. RESULTS: 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). CONCLUSION: 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.