Clinical characteristics and etiology analysis of nonvariceal upper gastrointestinal bleeding in the treatment of different antithrombotic drugs

Objective To explore clinical characteristics and etiology of complicating non-variceal upper gastrointestinal bleeding (NVUGIB) patients with different oral antithrombotic drug.

Methods Clinical data of 535 patients complicated with NVUGIB during oral administration of antithrombotic drugs were retrospectively analyzed and they were divided into antiplatelet group and anticoagulant group according to different types of antithrombotic drugs. General data, clinical characteristics and etiology of patients in the two groups were compared and analyzed.

Results The proportion of male in the antiplatelet group was higher than that in the anticoagulant group (P=0.012). The proportions of patients complicating coronary heart disease, hypertension and diabetes in the antiplatelet group were higher than that in anticoagulation group, and the proportion of patients complicating atrial fibrillation, heart valve disease, pulmonary embolism or deep vein thrombosis was lower than that in the anticoagulant group (P < 0.05). The proportion of patients with NVUGIB in the antiplatelet group within 1 month after taking the medicine was higher than that in the anticoagulant group (P < 0.05). The proportion of patients with chest tightness and chest pain in the antiplatelet group was higher than that in the anticoagulant group, while the proportion of patients with abdominal pain was lower than that in the anticoagulant group (P < 0.05). The proportion of patients using acid suppressant and Hp infection rate in the antiplatelet group were higher than those in the anticoagulant group (P < 0.05). The common causes of NVUGIB in the two groups were peptic ulcer, acute gastric mucosal lesion and malignant tumor.

Conclusion NVUGIB with oral antithrombotic therapy usually occur in elderly men. The top three causes are peptic ulcer, acute gastric mucosal lesion and malignant tumor. There are some differences in underlying diseases, oral duration of antithrombotic drugs, symptoms and etiology in antiplatelet and anticoagulant patients with NVUGIB. Thus, clinicians need to pay attention to their difference.