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Korean J Helicobacter  Up Gastrointest Res > Volume 18(4); 2018 > Article
The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2018;18(4):219-224.
DOI: https://doi.org/10.7704/kjhugr.2018.18.4.219    Published online December 10, 2018.
Risk Factors of Gastrointestinal Bleeding in Patients Receiving New Oral Anticoagulants
Ju Yup Lee 
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea. leejygi@naver.com
New Oral Anticoagulants를 복용하는 환자들에서 위장관 출혈의 위험인자
이주엽
계명대학교 의과대학 내과학교실
Correspondence:  Ju Yup Lee, Tel: +82-53-250-7088, Fax: +82-53-250-7442, 
Email: leejygi@naver.com
Received: 22 February 2018   • Revised: 28 April 2018   • Accepted: 29 April 2018
Abstract
New oral anticoagulants (NOACs) are now widely used for the prevention and treatment of venous thrombosis, and for the prevention of stroke and systemic embolism in patients with atrial fibrillation. As compared with warfarin, NOACs have the advantage of rapid onset of action and less drug interaction. However, they carry a higher risk of gastrointestinal (GI) bleeding than warfarin. The risk of GI bleeding in patients using NOACs varies according to the type and dose of the drug. By contrast, apixaban and edoxaban are reported to carry similar risks as warfarin, and the risks with dabigatran and rivaroxaban are higher than that with warfarin. In patients using NOACs, old age, impaired renal function, impaired liver function, concurrent use of antiplatelet agents, and nonsteroidal anti-inflammatory drugs are considered major risk factors of GI bleeding, and gastroprotective agents such as histamine-2 receptor antagonist and proton pump inhibitor have preventive effects. To prevent GI bleeding associated with NOACs, the characteristics of each NOAC and the risk factors of bleeding should be recognized.
Key Words: Apixaban; Dabigatran; Edoxaban; Gastrointestinal hemorrhage; Rivaroxaban


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