Peptic Ulcer Disease in Patients Under Antiplatelets or Anticoagulants: Analysis of Upper Gastrointestinal Endoscopy Findings

Aims Among others, peptic ulcer disease is associated with certain drug classes. Our aim was to analyze the risk of peptic ulcer disease (PUD) in patients with hematemesis/melena/hematochezia, receiving anticoagulant or antiplatelet therapy.

Methods Single-center, retrospective study, of patients who underwent upper GI endoscopy for the investigation of suspected gastrointestinal bleeding, in the General Hospital Of Ioannina, Greece, from January 2017 to October 2019. Only patients with non-variceal upper gastrointestinal bleeding were included in the study.

Results The data of 201 patients with hematemesis/melena/hematochezia were analyzed. 131 patients (88 males, mean age 75.9, median 77, StD 11.6 years) were on treatment that could be responsible for their bleeding episode.

In detail, 34 patients were treated with Direct Acting Oral Anticoagulants [DOACs], 42 patients with antiplatelets (12 of which were on dual antiplatelet therapy), 8 patients with Low Molecular Weight Heparin (LMWH), 9 patients with a combination of antiplatelets and DOACs, 19 patients with acenocoumarol, 15 patients with NSAIDs, and 4 patients with classic aspirin. 70 patients were not reported to receive any therapy prior to endoscopy.

PUD was found in 18/42 (42.9 %) of patients under antiplatelets, against 13/53 (24.5 %) (p = 0.06) treated with anticoagulants [in detail, 8/34 (23.5 %) treated with DOACs (p = 0.08) and 5/19 (26.3 %) treated with acenocoumarol (p = 0.2)] whereas 29/70 (41.4 %) were under no treatment (41.4 %) (p = 0.88).

Peptic ulcer disease was the cause of bleeding in 8/12 patients (66.7 %) treated with dual antiplatelet therapy.

Conclusions In non-variceal upper gastrointestinal bleeding, peptic ulcer disease is more frequently found in patients treated with antiplatelets compared to patients treated with anticoagulants.

This risk is increased in patients treated with dual antiplatelet therapy.

Citation: Mitselos I, Moutzoukis M, Lamouri C et al. eP88 PEPTIC ULCER DISEASE IN PATIENTS UNDER ANTIPLATELETS OR ANTICOAGULANTS: ANALYSIS OF UPPER GASTROINTESTINAL ENDOSCOPY FINDINGS. Endoscopy 2021; 53: S125.

Publication History

Article published online:
19 March 2021