{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T13:17:29Z","timestamp":1783171049950,"version":"3.54.6"},"reference-count":49,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100004853","name":"The Chinese University of Hong Kong","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004853","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cghjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinical Gastroenterology and Hepatology"],"published-print":{"date-parts":[[2026,4]]},"DOI":"10.1016\/j.cgh.2026.04.016","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T23:50:14Z","timestamp":1777333814000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of Complicated Upper Gastrointestinal Bleeding With Direct Oral Anticoagulants: An Asian Population-Based Analysis"],"prefix":"10.1016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4163-4531","authenticated-orcid":false,"given":"Louis H.S.","family":"Lau","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry C.F.","family":"Yip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonaventure Y.M.","family":"Ip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashid N.","family":"Lui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hon-Chi","family":"Yip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon M.","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip W.Y.","family":"Chiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Y.W.","family":"Lau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent W.S.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace L.H.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis K.L.","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.cgh.2026.04.016_bib1","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"45","author":"Van Gelder","year":"2024","journal-title":"Eur Heart J"},{"key":"10.1016\/j.cgh.2026.04.016_bib2","article-title":"Oral anticoagulants for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis, and cost effectiveness analysis","volume":"359","author":"L\u00f3pez-L\u00f3pez","year":"2017","journal-title":"BMJ"},{"key":"10.1016\/j.cgh.2026.04.016_bib3","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1056\/NEJMoa0905561","article-title":"Dabigatran versus warfarin in patients with atrial fibrillation","volume":"361","author":"Connolly","year":"2009","journal-title":"N Engl J Med"},{"key":"10.1016\/j.cgh.2026.04.016_bib4","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1056\/NEJMoa1009638","article-title":"Rivaroxaban versus warfarin in nonvalvular atrial fibrillation","volume":"365","author":"Patel","year":"2011","journal-title":"N Engl J Med"},{"key":"10.1016\/j.cgh.2026.04.016_bib5","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1056\/NEJMoa1107039","article-title":"Apixaban versus warfarin in patients with atrial fibrillation","volume":"365","author":"Granger","year":"2011","journal-title":"N Engl J Med"},{"key":"10.1016\/j.cgh.2026.04.016_bib6","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1056\/NEJMoa1310907","article-title":"Edoxaban versus warfarin in patients with atrial fibrillation","volume":"369","author":"Giugliano","year":"2013","journal-title":"N Engl J Med"},{"key":"10.1016\/j.cgh.2026.04.016_bib7","doi-asserted-by":"crossref","first-page":"2271","DOI":"10.1016\/j.jacc.2015.09.024","article-title":"Gastrointestinal bleeding in patients with atrial fibrillation treated with rivaroxaban or warfarin: ROCKET AF trial","volume":"66","author":"Sherwood","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.cgh.2026.04.016_bib8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0310322","article-title":"Comparative safety and effectiveness of oral anticoagulants in patients with non-valvular atrial fibrillation and high risk of gastrointestinal bleeding: a nationwide French cohort study","volume":"19","author":"Lip","year":"2024","journal-title":"PLoS One"},{"key":"10.1016\/j.cgh.2026.04.016_bib9","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S2468-1253(16)30162-5","article-title":"Risk of gastrointestinal bleeding with direct oral anticoagulants: a systematic review and network meta-analysis","volume":"2","author":"Burr","year":"2017","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"10.1016\/j.cgh.2026.04.016_bib10","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.cgh.2022.06.033","article-title":"Warfarin is associated with higher rates of upper but not lower gastrointestinal bleeding compared with direct oral anticoagulants: a population-based propensity-weighted cohort study","volume":"21","author":"Ingason","year":"2023","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1016\/j.cgh.2026.04.016_bib11","doi-asserted-by":"crossref","DOI":"10.1111\/hel.12990","article-title":"Risk of hospitalization for upper gastrointestinal bleeding in Helicobacter pylori eradicated patients newly started on warfarin or direct oral anticoagulants: a population-based cohort study","volume":"28","author":"Jiang","year":"2023","journal-title":"Helicobacter"},{"key":"10.1016\/j.cgh.2026.04.016_bib12","article-title":"Risks and benefits of direct oral anticoagulants versus warfarin in a real world setting: cohort study in primary care","volume":"362","author":"Vinogradova","year":"2018","journal-title":"BMJ"},{"key":"10.1016\/j.cgh.2026.04.016_bib13","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1111\/apt.16236","article-title":"Outcomes of upper gastrointestinal bleeding are similar between direct oral anticoagulants and vitamin K antagonists","volume":"53","author":"Gouriou","year":"2021","journal-title":"Aliment Pharmacol Ther"},{"key":"10.1016\/j.cgh.2026.04.016_bib14","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1097\/MCG.0000000000001796","article-title":"Safety of direct oral anticoagulants for gastrointestinal hemorrhage in patients with nonvalvular atrial fibrillation: a systematic review and meta-analysis of real-world studies: a systematic review and meta-analysis of real-world studies","volume":"57","author":"Archontakis Barakakis","year":"2023","journal-title":"J Clin Gastroenterol"},{"key":"10.1016\/j.cgh.2026.04.016_bib15","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1053\/j.gastro.2016.12.018","article-title":"Gastrointestinal safety of direct oral anticoagulants: a large population-based Study","volume":"152","author":"Abraham","year":"2017","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2026.04.016_bib16","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.7326\/M21-1474","article-title":"Rivaroxaban is associated with higher rates of gastrointestinal bleeding than other direct oral anticoagulants: a nationwide propensity score-weighted study","volume":"174","author":"Ingason","year":"2021","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.cgh.2026.04.016_bib17","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.7326\/M22-0511","article-title":"Comparative effectiveness and safety between apixaban, dabigatran, edoxaban, and rivaroxaban among patients with atrial fibrillation : a multinational population-based cohort study","volume":"175","author":"Lau","year":"2022","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.cgh.2026.04.016_bib18","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1001\/jamainternmed.2025.1109","article-title":"Oral anticoagulation and risk of adverse clinical outcomes in venous thromboembolism","volume":"185","author":"Bea","year":"2025","journal-title":"JAMA Intern Med"},{"key":"10.1016\/j.cgh.2026.04.016_bib19","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1055\/a-2316-5269","article-title":"Edoxaban, rivaroxaban, or apixaban for cancer-associated venous thromboembolism in the real world: insights from the COMMAND VTE Registry-2","volume":"124","author":"Sueta","year":"2024","journal-title":"Thromb Haemost"},{"key":"10.1016\/j.cgh.2026.04.016_bib20","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.chest.2019.04.108","article-title":"Effectiveness and safety of four direct oral anticoagulants in Asian patients with nonvalvular atrial fibrillation","volume":"156","author":"Chan","year":"2019","journal-title":"Chest"},{"key":"10.1016\/j.cgh.2026.04.016_bib21","doi-asserted-by":"crossref","first-page":"2245","DOI":"10.1161\/STROKEAHA.119.025536","article-title":"Effectiveness and safety of contemporary oral anticoagulants among Asians with nonvalvular atrial fibrillation","volume":"50","author":"Lee","year":"2019","journal-title":"Stroke"},{"key":"10.1016\/j.cgh.2026.04.016_bib22","doi-asserted-by":"crossref","first-page":"723","DOI":"10.4240\/wjgs.v15.i4.723","article-title":"The global epidemiology of upper and lower gastrointestinal bleeding in general population: a systematic review","volume":"15","author":"Saydam","year":"2023","journal-title":"World J Gastrointest Surg"},{"key":"10.1016\/j.cgh.2026.04.016_bib23","doi-asserted-by":"crossref","DOI":"10.1155\/2018\/7123607","article-title":"Difference between the upper and the lower gastrointestinal bleeding in patients taking nonvitamin K oral anticoagulants","volume":"2018","author":"Maruyama","year":"2018","journal-title":"Biomed Res Int"},{"key":"10.1016\/j.cgh.2026.04.016_bib24","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1253\/circj.CJ-15-1082","article-title":"Edoxaban vs. warfarin in east Asian patients with atrial fibrillation - an ENGAGE AF-TIMI 48 subanalysis","volume":"80","author":"Yamashita","year":"2016","journal-title":"Circ J"},{"key":"10.1016\/j.cgh.2026.04.016_bib25","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1093\/eurheartj\/ehy807","article-title":"Clinical outcomes, edoxaban concentration, and anti-factor Xa activity of Asian patients with atrial fibrillation compared with non-Asians in the ENGAGE AF-TIMI 48 trial","volume":"40","author":"Chao","year":"2019","journal-title":"Eur Heart J"},{"key":"10.1016\/j.cgh.2026.04.016_bib26","doi-asserted-by":"crossref","first-page":"e23","DOI":"10.15420\/ecr.2020.43","article-title":"Direct oral anticoagulants in Asian patients with atrial fibrillation: consensus recommendations by the Asian Pacific Society of Cardiology on strategies for thrombotic and bleeding risk management","volume":"16","author":"Chong","year":"2021","journal-title":"Eur Cardiol"},{"key":"10.1016\/j.cgh.2026.04.016_bib27","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1136\/gutjnl-2018-316276","article-title":"Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018","volume":"67","author":"Sung","year":"2018","journal-title":"Gut"},{"key":"10.1016\/j.cgh.2026.04.016_bib28","doi-asserted-by":"crossref","DOI":"10.1016\/j.thromres.2025.109352","article-title":"All-cause mortality after major gastrointestinal bleeding among patients receiving direct oral anticoagulants: a systematic review and meta-analysis","volume":"252","author":"Chornenki","year":"2025","journal-title":"Thromb Res"},{"key":"10.1016\/j.cgh.2026.04.016_bib29","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1136\/gutjnl-2020-323600","article-title":"Risks of post-colonoscopic polypectomy bleeding and thromboembolism with warfarin and direct oral anticoagulants: a population-based analysis","volume":"71","author":"Lau","year":"2022","journal-title":"Gut"},{"key":"10.1016\/j.cgh.2026.04.016_bib30","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.1136\/gutjnl-2020-323054","article-title":"Timing of endoscopy for acute upper gastrointestinal bleeding: a territory-wide cohort study","volume":"71","author":"Guo","year":"2022","journal-title":"Gut"},{"key":"10.1016\/j.cgh.2026.04.016_bib31","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1056\/NEJMoa2102953","article-title":"New creatinine- and cystatin C-based equations to estimate GFR without race","volume":"385","author":"Inker","year":"2021","journal-title":"N Engl J Med"},{"key":"10.1016\/j.cgh.2026.04.016_bib32","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1378\/chest.09-1584","article-title":"Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation","volume":"137","author":"Lip","year":"2010","journal-title":"Chest"},{"key":"10.1016\/j.cgh.2026.04.016_bib33","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1378\/chest.10-0134","article-title":"A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey","volume":"138","author":"Pisters","year":"2010","journal-title":"Chest"},{"key":"10.1016\/j.cgh.2026.04.016_bib34","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"10.1016\/j.cgh.2026.04.016_bib35","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1053\/j.gastro.2025.04.041","article-title":"Canadian Association of Gastroenterology Clinical Practice Guideline for the endoscopic management of nonvariceal nonpeptic ulcer upper gastrointestinal bleeding","volume":"169","author":"Barkun","year":"2025","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2026.04.016_bib36","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1093\/ckj\/sfab158","article-title":"An introduction to inverse probability of treatment weighting in observational research","volume":"15","author":"Chesnaye","year":"2022","journal-title":"Clin Kidney J"},{"key":"10.1016\/j.cgh.2026.04.016_bib37","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1056\/NEJMoa2510703","article-title":"Bleeding risk with apixaban vs. rivaroxaban in acute venous thromboembolism","volume":"394","author":"Castellucci","year":"2026","journal-title":"N Engl J Med"},{"key":"10.1016\/j.cgh.2026.04.016_bib38","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1093\/ehjqcco\/qcab048","article-title":"Effectiveness and safety of non-vitamin K antagonist oral anticoagulants and warfarin in atrial fibrillation: a Scandinavian population-based cohort study","volume":"8","author":"Halvorsen","year":"2022","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"10.1016\/j.cgh.2026.04.016_bib39","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1002\/cpt.2881","article-title":"Comparison of efficacy and safety of direct oral anticoagulants and warfarin between patients in Asian and non-Asian regions: a systematic review and meta-regression analysis","volume":"113","author":"Ambe","year":"2023","journal-title":"Clin Pharmacol Ther"},{"key":"10.1016\/j.cgh.2026.04.016_bib40","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.bcp.2016.09.003","article-title":"Dabigatran etexilate activation is affected by the CES1 genetic polymorphism G143E (rs71647871) and gender","volume":"119","author":"Shi","year":"2016","journal-title":"Biochem Pharmacol"},{"key":"10.1016\/j.cgh.2026.04.016_bib41","first-page":"477","article-title":"The impact of ABCB1 and CES1 polymorphisms on dabigatran pharmacokinetics in healthy Chinese subjects","volume":"14","author":"Liu","year":"2021","journal-title":"Pharmgenomics Pers Med"},{"key":"10.1016\/j.cgh.2026.04.016_bib42","doi-asserted-by":"crossref","first-page":"2247","DOI":"10.1111\/bcp.14646","article-title":"The impact of ABCB1 and CES1 polymorphisms on dabigatran pharmacokinetics and pharmacodynamics in patients with atrial fibrillation","volume":"87","author":"Ji","year":"2021","journal-title":"Br J Clin Pharmacol"},{"key":"10.1016\/j.cgh.2026.04.016_bib43","doi-asserted-by":"crossref","DOI":"10.1002\/ctm2.1104","article-title":"Genetic variations in relation to bleeding and pharmacodynamics of dabigatran in Chinese patients with nonvalvular atrial fibrillation: a nationwide multicentre prospective cohort study","volume":"12","author":"Xiang","year":"2022","journal-title":"Clin Transl Med"},{"key":"10.1016\/j.cgh.2026.04.016_bib44","doi-asserted-by":"crossref","DOI":"10.1002\/ctm2.1263","article-title":"Genetic variants influenced the risk of bleeding and pharmacodynamics of rivaroxaban in patients with nonvalvular atrial fibrillation: a multicentre prospective cohort study","volume":"13","author":"Xiang","year":"2023","journal-title":"Clin Transl Med"},{"key":"10.1016\/j.cgh.2026.04.016_bib45","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1007\/s40262-024-01358-3","article-title":"Toward genetic testing of rivaroxaban? Insights from a systematic review on the role of genetic polymorphism in rivaroxaban therapy","volume":"63","author":"Ma","year":"2024","journal-title":"Clin Pharmacokinet"},{"key":"10.1016\/j.cgh.2026.04.016_bib46","doi-asserted-by":"crossref","DOI":"10.3389\/fgene.2022.982955","article-title":"Genetic determinants of apixaban plasma levels and their relationship to bleeding and thromboembolic events","volume":"13","author":"Attelind","year":"2022","journal-title":"Front Genet"},{"key":"10.1016\/j.cgh.2026.04.016_bib47","doi-asserted-by":"crossref","first-page":"4771","DOI":"10.1038\/s41598-024-55500-z","article-title":"Mortality after major bleeding in Asian atrial fibrillation patients receiving different direct oral anticoagulants: a nationwide, propensity score study","volume":"14","author":"Yu","year":"2024","journal-title":"Sci Rep"},{"key":"10.1016\/j.cgh.2026.04.016_bib48","doi-asserted-by":"crossref","first-page":"814","DOI":"10.5009\/gnl230406","article-title":"Real-world risk of gastrointestinal bleeding for direct oral anticoagulants and warfarin users: a distributed network analysis using a common data model","volume":"18","author":"Cha","year":"2024","journal-title":"Gut Liver"},{"key":"10.1016\/j.cgh.2026.04.016_bib49","doi-asserted-by":"crossref","first-page":"9688","DOI":"10.1038\/s41598-024-59932-5","article-title":"Gastrointestinal bleeding in elderly patients with atrial fibrillation: prespecified All Nippon Atrial Fibrillation in the Elderly (ANAFIE) Registry subgroup analysis","volume":"14","author":"Yamamoto","year":"2024","journal-title":"Sci Rep"}],"container-title":["Clinical Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1542356526003198?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1542356526003198?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T12:33:38Z","timestamp":1783168418000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1542356526003198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":49,"alternative-id":["S1542356526003198"],"URL":"https:\/\/doi.org\/10.1016\/j.cgh.2026.04.016","relation":{},"ISSN":["1542-3565"],"issn-type":[{"value":"1542-3565","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Risk of Complicated Upper Gastrointestinal Bleeding With Direct Oral Anticoagulants: An Asian Population-Based Analysis","name":"articletitle","label":"Article Title"},{"value":"Clinical Gastroenterology and Hepatology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.cgh.2026.04.016","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 American Gastroenterological Association Institute. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}