Effect of Second-look Endoscopy on Peptic Ulcer Rebleeding in Patients With Early Resumption of Antiplatelet Agents
Status:
Terminated
Trial end date:
2017-09-01
Target enrollment:
Participant gender:
Summary
OBJECTIVES: Up to 15% of patients with peptic ulcer bleeding will develop rebleeding, mainly
in those with ulcers of higher-risk stigmata (i.e. Forrest class Ia to IIb). Randomized
trials show that second-look endoscopy is effective in reducing rebleeding rate. However,
whether to withhold aspirin or other anti-platelet agents (for the treatment of established
cardiovascular or cerebrovascular diseases) remains controversial. Studies have shown that
although continuation of anti-platelet agents reduces mortality rate due to reduced
cardiovascular and cerebrovascular events, there is a marginal increase in rebleeding risk.
HYPOTHESIS: We hypothesize that continuation of aspirin or other anti-platelet agents coupled
with second-look endoscopy could reduce the rebleeding rate without increasing the risk of
thromboembolic events in high-risk patients.