{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T23:10:14Z","timestamp":1740784214201,"version":"3.38.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2012,5,1]],"date-time":"2012-05-01T00:00:00Z","timestamp":1335830400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Scott Med J"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:p> Upper gastrointestinal haemorrhage (UGIH) in cardiac patients receiving antiplatelets presents a difficult management problem. The aim of this study was to describe a series of cardiac inpatients receiving antiplatelets who underwent endoscopy for an acute UGIH. Cardiac inpatients receiving antiplatelets and requiring endoscopy for UGIH over an 18-month period were followed up. Forty-one patients were studied. Most patients (25 [61%]) presented with melaena. Antiplatelets were withheld in 34 (83%) patients; predominantly in those with higher pre-endoscopy Rockall scores (median, 4; interquartile range [IQR], 3\u20135 versus median, 3; IQR, 2\u20134; P &lt; 0.05). Positive findings were identified at endoscopy in 80%. Duodenal ulcers were the most common lesion and adrenaline the most common method of haemostasis. Median time to first endoscopy was 0 (IQR, 0\u20131) days. Seven (17%) patients re-bled, median Rockall score was six (IQR, 4\u20138). Three (7%) patients experienced procedural complications, two patients became hypoxic and one patient died. Following endoscopy, antiplatelets were restarted after a median of three (IQR, 3\u20135) days. On discharge, 27\/28 (96%) patients continued with antiplatelet and proton-pump inhibitor therapy. Thirty-day inpatient mortality was 7% (3 patients). One patient re-bled within six months of discharge. Endoscopy helped assess the risk of re-bleeding and timing of antiplatelet re-introduction in cardiac inpatients experiencing UGIH. <\/jats:p>","DOI":"10.1258\/smj.2012.012006","type":"journal-article","created":{"date-parts":[[2012,5,3]],"date-time":"2012-05-03T15:38:18Z","timestamp":1336059498000},"page":"88-91","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Upper gastrointestinal haemorrhage in the acute cardiac care setting: antiplatelets and endoscopy"],"prefix":"10.1177","volume":"57","author":[{"given":"S A","family":"Musa","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, St George's Hospital, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S J","family":"Brecker","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St George's Hospital, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T M","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, St George's Hospital, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J Y","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, St George's Hospital, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2012,5,3]]},"reference":[{"key":"bibr1-smj.2012.012006","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2006.02759.x"},{"key":"bibr2-smj.2012.012006","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-008-2215-4"},{"key":"bibr3-smj.2012.012006","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e3282f16a3a"},{"key":"bibr4-smj.2012.012006","doi-asserted-by":"publisher","DOI":"10.1155\/2009\/509258"},{"key":"bibr5-smj.2012.012006","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-152-1-201001050-00179"},{"key":"bibr6-smj.2012.012006","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.142497"},{"key":"bibr7-smj.2012.012006","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.191087"},{"key":"bibr8-smj.2012.012006","unstructured":"Scottish Intercollegiate Guidelines Network. 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