ArticleJournal of gastroenterology2025
Optimal direct oral anticoagulant for upper gastrointestinal endoscopic submucosal dissection.
Article in Journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Accounting for resumption timing in evaluating the safety of oral anticoagulants following upper gastrointestinal endoscopic submucosal dissection.Journal of gastroenterology · 2026Article
- Reply to "Accounting for resumption timing in evaluating the safety of oral anticoagulants following upper gastrointestinal endoscopic submucosal dissection".Journal of gastroenterology · 2026Article
- Effect of Oral Proton-Pump Inhibitor Administration on Reducing the Delayed Bleeding Risk in 5 Upper Gastrointestinal Endoscopic Treatments.The American journal of gastroenterology · 2026Article
- Response to "optimal direct oral anticoagulant for upper gastrointestinal endoscopic submucosal dissection".Journal of gastroenterology · 2026Article
- Reply to "Response to 'Optimal direct oral anticoagulant for upper gastrointestinal endoscopic submucosal dissection'".Journal of gastroenterology · 2026Article
- Dabigatran outperforms warfarin in elderly patients with atrial fibrillation and stable coronary artery disease: reduced risks of bleeding and cardiovascular events.American journal of translational research · 2026Article
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16 authors.
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Abstract
backgroundThe patients taking direct oral anticoagulants (DOACs) are at high risk for developing ischemic stroke and delayed bleeding in upper gastrointestinal endoscopic submucosal dissection (ESD). We aimed to identify the optimal DOAC based on both adverse events in upper gastrointestinal ESD.
methodsA retrospective population-based cohort study was conducted using the Diagnosis Procedure Combination database in Japan. We included patients on a DOAC undergoing upper gastrointestinal ESD between 2012 and 2021. The primary outcomes were ischemic stroke occurring after upper gastrointestinal ESD and delayed bleeding in gastroduodenal and esophageal ESD. Inverse probability weightings were applied to balance the four DOAC groups (dabigatran, rivaroxaban, apixaban, and edoxaban), and logistic regression analyses were performed to compare the outcomes.
resultsWe analyzed 9729 patients on a DOAC undergoing upper gastrointestinal ESD. Ischemic stroke developed after upper gastrointestinal ESD in 1.4%, 0.7%, 0.6%, and 0.8% of patients taking dabigatran, rivaroxaban, apixaban, and edoxaban, respectively, after weighting. Rivaroxaban and apixaban showed significantly lower risk of ischemic stroke compared with dabigatran (odds ratio, 0.15 and 0.12, respectively) in standard doses. The delayed bleeding developed after gastroduodenal ESD in 7.6%, 14.6%, 19.2%, and 17.3% of patients taking each DOAC, respectively, with the lowest risk in dabigatran, followed by rivaroxaban. A similar pattern was observed in delayed bleeding in esophageal ESD (3.2%, 5.4%, 7.5%, and 5.5% in each DOAC), but with no significant results.
conclusionsRivaroxaban might be an optimal DOAC for upper gastrointestinal ESD showing a lower risk for both ischemic stroke and delayed bleeding.
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