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Multicenter study on hemorrhagic risk of heparin bridging therapy for periendoscopic thromboprophylaxis

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Title: Multicenter study on hemorrhagic risk of heparin bridging therapy for periendoscopic thromboprophylaxis
Authors: Matsumoto, Mio Browse this author
Mabe, Katsuhiro Browse this author
Tsuda, Momoko Browse this author
Ono, Masayoshi Browse this author
Omori, Saori Browse this author
Takahashi, Masakazu Browse this author
Yoshida, Takeshi Browse this author
Ono, Shoko Browse this author
Nakagawa, Manabu Browse this author
Nakagawa, Soichi Browse this author
Shimizu, Yuichi Browse this author →KAKEN DB
Kudo, Takahiko Browse this author
Sakamoto, Naoya Browse this author →KAKEN DB
Kato, Mototsugu Browse this author →KAKEN DB
Keywords: Endoscopic treatment
Post-procedural bleeding
Thrombosis
Antithrombotic therapy
Issue Date: 29-Jul-2015
Publisher: BioMed Central
Journal Title: BMC gastroenterology
Volume: 15
Start Page: 89
Publisher DOI: 10.1186/s12876-015-0315-1
Abstract: Background: For endoscopic interventions, heparin bridging therapy is recommended in patients who are at high risk from interruption of antithrombotic therapy. Although heparin bridging has been reported to be effective in preventing thrombosis, several reports have raised concerns about increased risk of bleeding. The aim of this study was to clarify complications of hepari bridging therapy in therapeutic endoscopy. Methods: A nationwide multicenter survey using questionnaire was performed about patients undergoing therapeutic endoscopy with heparin bridging. Patients who underwent therapeutic endoscopy without heparin bridging therapy were considered as controls. Compliance scores of heparin bridging therapy guideline were employed, and association was analyzed between the score and occurrence of post-procedural bleeding. Results: The incidence of post-procedural bleeding was significantly higher (13.5 %, 33/245) in the heparin group compared with the control group (2.7 %, 299/11102)(p < 0.001). Thrombosis occurred in 1 patient each in the two groups. In the heparin group, post-procedural bleeding was more likely to be delayed bleeding. Dose adjustment of heparin was a significant factor contributing to bleeding. The compliance score of heparin bridging therapy guideline was significantly higher in those who suffered bleeding. Conclusions: Heparin bridging therapy significantly increased the risk of post-procedural bleeding compared with the control. The bleeding risk was associated with greater adherence with guidelines for heparin bridging therapy.
Rights: http://creativecommons.org/licenses/by/4.0
Type: article
URI: http://hdl.handle.net/2115/59829
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 加藤 元嗣

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