Management of Antiplatelet Agents and Anticoagulants in Patients with Gastrointestinal Bleeding

Abstract

Antithrombotic drugs (anticoagulants, aspirin, and other antiplatelet agents) are used to treat cardiovascular disease and to prevent secondary thromboembolic events. These drugs are independently associated with an increased risk of gastrointestinal bleeding (GIB), and, when prescribed in combination, further increase the risk of adverse bleeding events. Clinical evidence to inform the choice of endoscopic hemostatic procedure, safe temporary drug cessation, and use of reversal agents is reviewed to optimize management following clinically significant GIB.

Keywords: Adverse effects; Gastrointestinal hemorrhage; Lower gastrointestinal bleeding; Novel oral anticoagulant; Thienopyridine; Upper gastrointestinal bleeding.