Professor Petrozavodsk State University Petrozavodsk, Karelia, Russia
Background: We use anticoagulants widely now. But we must remember, that these drugs can lead to very dangerous bleeding, including gastroduodenal one.
Aims: To estimate the gastroduodenal bleeding risk in the group of patients with VTE, receiving anticoagulants and to work out the safe algorithm for their application and primary and secondary prevention tactics.
Methods: 731 patients with VTE were treated. Venous ultrasonography was made in all cases. D-dimer was done according to indications. 722 patients underwent gastro-duodenoscopy before treatment.
Results: There were no signs of gastric problems in 84 patients. This group received anticoagulants. The second group 538 patients had gastric problems, but without signs of bleeding. The third group (86 patients had gastric or duodenal bleeding during the investigation, but it was stopped using coagulation with stable hemostasis. Anticoagulants together with proton pump inhibitor (omeprazol or esomeprazol) were administrated. The fourth group had gastric or duodenal bleeding which was stopped during the gastro-duodenoscopy, but the hemostasis was unstable. Proton pump inhibitor was administrated initially. After second gastro-duodenoscopy anticoagulants were administrated if the bleeding was not continued.
Conclusion(s): The use of proton pump inhibitor together with anticoagulant drug can prevent the bleeding. The use of gastro-duodenoscopy and adequate treatment make the use of anticoagulant drug safety.
.jpg "Ernest A. Shchegov, MD PhD photo")