Timing of Endoscopy in Coronary Heart Disease Patients Taking Antiplatelet Drugs With Acute Non-variceal Upper Gastrointestinal Bleeding

A Prospective Randomized Controlled Study on the Timing of Endoscopy in Coronary Heart Disease Patients Taking Antiplatelet Drugs With Acute Non-variceal Upper Gastrointestinal Bleeding

This is a prospective randomized controlled trial (RCT) evaluating the optimal timing of endoscopy in patients with coronary heart disease who are taking antiplatelet drugs and present with acute non-variceal upper gastrointestinal bleeding.

Eligible patients will be randomly assigned to one of two groups: an urgent endoscopy group (undergoing endoscopy within 12 hours of hospital admission) or an early endoscopy group (undergoing endoscopy between 12 and 24 hours after admission). All patients will receive standard medical treatment for upper gastrointestinal bleeding and antiplatelet management in accordance with current clinical guidelines.

The primary outcome of this study is the incidence of major adverse cardiovascular events (MACE) within 30 days between the two groups. Secondary outcomes include further bleeding events, all-cause mortality, length of hospital stay, and the need for blood transfusion during the follow-up period.

This research aims to generate evidence-based clinical guidance on the safest and most effective endoscopy timing for this high-risk patient population.

Inclusion Criteria:

• Age ≥ 18 years
• Patients with coronary heart disease receiving antiplatelet therapy
• Patients who can tolerate general anesthesia and endoscopy after anesthesia evaluation
• Voluntary participation in the clinical trial and signed informed consent

Exclusion Criteria:

• Patients with unstable vital signs despite fluid resuscitation, blood transfusion, and other supportive treatments
• Presence of contraindications to endoscopy
• Patients with confirmed or suspected variceal upper gastrointestinal bleeding
• Gastrointestinal bleeding suspected to originate from the middle or lower gastrointestinal tract