{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T19:40:45Z","timestamp":1770838845765,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,4,24]],"date-time":"2017-04-24T00:00:00Z","timestamp":1492992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Anticoagulants are used to prevent thromboembolic events. Direct oral anticoagulants (<jats:styled-content style=\"fixed-case\">DOAC<\/jats:styled-content>) are our new choice; however, their effect on bleeding risk for endoscopic treatment has not been reported. We aimed to assess the clinical effect of <jats:styled-content style=\"fixed-case\">DOAC<\/jats:styled-content> compared to warfarin for gastric endoscopic submucosal dissection (<jats:styled-content style=\"fixed-case\">ESD<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively studied 97 patients on anticoagulants and treated 108 gastric neoplasms with <jats:styled-content style=\"fixed-case\">ESD<\/jats:styled-content> in three referral institutes. Twenty\u2010four patients were taking <jats:styled-content style=\"fixed-case\">DOAC<\/jats:styled-content>, including dabigatran (12), rivaroxaban (11), and apixaban (one) and 73 were taking warfarin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the <jats:styled-content style=\"fixed-case\">DOAC<\/jats:styled-content> group, delayed bleeding rate was significantly higher in patients on rivaroxaban than in patients on dabigatran (45% <jats:italic>vs<\/jats:italic> 0%, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05) without relation to heparin bridge therapy (<jats:styled-content style=\"fixed-case\">HBT<\/jats:styled-content>). In the warfarin group, 78% of patients underwent <jats:styled-content style=\"fixed-case\">HBT<\/jats:styled-content>, and delayed bleeding rate was significantly higher in patients with <jats:styled-content style=\"fixed-case\">HBT<\/jats:styled-content> than in those without (36% <jats:italic>vs<\/jats:italic> 0%, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05). Delayed bleeding rate increased as intake of antithrombotic agents increased (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05). <jats:styled-content style=\"fixed-case\">HBT<\/jats:styled-content> period was shorter (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05) in <jats:styled-content style=\"fixed-case\">DOAC<\/jats:styled-content> because <jats:styled-content style=\"fixed-case\">DOAC<\/jats:styled-content> achieve the maximum effect quicker, and hospitalization period was shorter (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05), compared with warfarin. Multivariate analysis showed that <jats:styled-content style=\"fixed-case\">HBT<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 10.7), rivaroxaban (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 6.00) and multiple antithrombotic agents (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 4.35) were independent delayed bleeding risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">DOAC<\/jats:styled-content> effect differs in each agent. Dabigatran is a feasible alternative to warfarin for shortening the hospitalization period and decreasing delayed bleeding rate, although rivaroxaban has a significantly higher delayed bleeding risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.12859","type":"journal-article","created":{"date-parts":[[2017,3,10]],"date-time":"2017-03-10T15:37:30Z","timestamp":1489160250000},"page":"686-694","source":"Crossref","is-referenced-by-count":41,"title":["Effect of direct oral anticoagulants on the risk of delayed bleeding after gastric endoscopic submucosal dissection"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6546-0329","authenticated-orcid":false,"given":"Toshiyuki","family":"Yoshio","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Cancer Institute Hospital Japanese Foundation for Cancer Research Tokyo 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