Characteristics, location, and clinical outcomes of gastrointestinal bleeding in patients taking new oral anticoagulants compared to vitamin k antagonists

A. Reum Choe, Chang Mo Moon, Chung Hyun Tae, Jaeyoung Chun, Ki Bae Bang, Yoo Jin Lee, Hyun Seok Lee, Yunho Jung, Sung Chul Park, Hoon Sup Koo

Research output: Contribution to journalArticlepeer-review

Abstract

New oral anticoagulants (NOACs) are commonly used in clinical practice as alternatives to vitamin K antagonists (VKA). However, the etiology, clinical course, and risk of gastrointestinal (GI) bleeding remain unclear. We aimed to evaluate the clinical characteristics and location of acute GI bleeding associated with NOACs and its severity and outcomes compared to VKA. This retrospective multicenter study included 381 subjects on anticoagulants who underwent appropriate diagnostic examination due to GI bleeding. Regarding the characteristics of acute GI bleeding, the proportion of vascular lesions was significantly lower in the NOACs group than that in the VKA group. Small bowel bleeding occurred less commonly in the NOACs group, but the difference did not reach statistical significance. Regarding severity and clinical outcomes, patients on NOACs received significantly smaller volumes of transfused blood products and had shorter ICU stays than those on VKA. Moreover, the need for surgery and the risk of rebleeding in the NOACs group were significantly lower than those in the VKA group. Patients on NOACs have better clinical outcomes in terms of severity of acute GI bleeding or rebleeding than patients on VKA. Patients on NOACs demonstrate different characteristics and location of acute GI bleeding than those on VKA.

Original languageEnglish
Article number2693
JournalJournal of Clinical Medicine
Volume10
Issue number12
DOIs
StatePublished - 2 Jun 2021

Keywords

  • Gastrointestinal bleeding
  • New oral anticoagulants
  • Rebleeding
  • Vitamin K antagonist

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