Abstract
Antithrombotic agent name, underlying disease, discontinuation of agent and determinator of discontinuation were investigated in 100 patients (86 males, 14 females, average age 68.3 y.o.) under antithrombotic therapy among 953 patients who underwent endoscopic upper GI cancer screening. One hundred patients were divided into two groups; 50 patients before and 50 patients after the explanation of antithrombotic therapy was added in the informed consent document in August 2010. The three most commonly administered agents were 59 aspirin, 16 warfarin, and 8 clopidogrel. Representative underlying diseases were 22 arrhythmia like atrial fibrillation, 17 old cerebral infarction, and 13 angina pectoris. Twelve patients (2 patients before and 10 patients after the informed consent) discontinued antithrombotic therapy by themselves, including 2 patients administered warfarin due to arrhythmia like atrial fibrillation who are considered to have a high risk of a thromboembolic event. After the explanation of antithrombotic therapy in August 2010, the number of patients who discontinued antithrombotic therapy by themselves was significantly higher than before the informed consent. The explanation of antithrombotic therapy in August 2010 was evaluated as inadequate to prevent discontinuation of the agent without a doctor's consultation. Corresponding to the new guideline of endoscopic procedures with antithrombotic agents in our department, patients have been informed that antithrombotic therapy should be continued generally. When a biopsy is needed, patients are referred to other medical institutes. Considering opinions of the doctors at other health check-up institutes, only when a doctor's permission for discontinuation of an agent is obtained, can the biopsy be performed after confirmation of the doctor's permission in every endoscopic procedure.
