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Tuesday Poster Session

Category: General Endoscopy

P5112 - Comparative Safety of Anticoagulants and Antiplatelet Agents in Upper GI Endoscopic Dilation Procedures

Tuesday, October 28, 2025
10:30 AM - 4:00 PM MT
Location: Exhibit Hall
Osama Alshakhatreh, MD1, Ibrahim Mohammed, MD1, Omar Arman, MD, MPH2, Mohammed Mohammed, 3, Seth Richter, MD, FACG1
1Albany Medical Center, Albany, NY; 2University at Buffalo, Buffalo, NY; 3Ain Shams University, Cairo, Al Qahirah, Egypt

Introduction: Upper gastrointestinal endoscopic dilation is commonly performed for benign strictures, but it carries a risk of complications such as bleeding. The use of anticoagulant (AC) or antiplatelet (AP) therapy may increase this risk, yet data on their safety in this context remain limited.

Methods: An analysis using TriNetX was conducted to compare outcomes between patients on anticoagulant (AC) therapy (e.g., warfarin, DOACs) and those on antiplatelet (AP) agents (e.g., aspirin, clopidogrel) within 7 days of undergoing upper gastrointestinal endoscopic dilation. A total of 4,226 AC patients and 14,878 AP patients were identified. Patients were propensity-matched 1:1 based on demographics and key clinical variables, resulting in 4,103 matched pairs. The primary outcomes assessed within 30 days post-procedure were GI bleeding, transfusion, and hospitalization.

Results: GI bleeding was more frequent among AC users (15.3%) compared to AP users (11.7%). Similarly, transfusion requirements were higher in the AC group (18.6% vs. 12.9%). Kaplan-Meier survival curves and risk analyses indicated a statistically significant increase in post-procedure complications in patients on anticoagulation compared to those on antiplatelet therapy.

Discussion: Our study aimed to evaluate the risk of gastrointestinal bleeding and related outcomes following upper GI endoscopic dilation in patients on anticoagulant or antiplatelet therapy compared to non-users. We found that medication users had a significantly higher risk of GI bleeding, emphasizing the need for cautious peri-procedural planning in this population.

Disclosures:
Osama Alshakhatreh indicated no relevant financial relationships.
Ibrahim Mohammed indicated no relevant financial relationships.
Omar Arman indicated no relevant financial relationships.
Mohammed Mohammed indicated no relevant financial relationships.
Seth Richter indicated no relevant financial relationships.

Osama Alshakhatreh, MD1, Ibrahim Mohammed, MD1, Omar Arman, MD, MPH2, Mohammed Mohammed, 3, Seth Richter, MD, FACG1. P5112 - Comparative Safety of Anticoagulants and Antiplatelet Agents in Upper GI Endoscopic Dilation Procedures, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.