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First study examines postpolypectomy bleeding in colonoscopy patients on uninterrupted clopidogrel
Date:5/19/2010

OAK BROOK, Ill. May 19, 2010 Researchers at the Syracuse Veterans Affairs Medical Center in New York examined postpolypectomy bleeding in patients undergoing colonoscopy on uninterrupted clopidogrel and found that the postpolypectomy bleeding rate is significantly higher in patients undergoing polypectomy while taking clopidogrel and concomitant aspirin/nonsteroidal anti-inflammatory drugs, but that the risk is small and the outcome is favorable. This is the first study to evaluate postpolypectomy bleeding in patients on uninterrupted clopidogrel therapy and concludes that routine cessation of clopidogrel in patients before colonoscopy polypectomy is not necessary. The study appears in the May issue of GIE: Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy (ASGE).

Colonoscopy is recommended as the primary screening method for colorectal cancer because of the ability to diagnose and remove polyps (growths in the colon) before they become cancer. Polyp removal is also referred to as polypectomy. Bleeding is the most common complication of colonoscopic polypectomy, ranging from 0.3 percent to 3.6 percent per patient. A number of factors contribute to postpolypectomy bleeding (PPB), among them, anticoagulants significantly increase the risk of PPB, whereas antiplatelet agents, aspirin (ASA), and other nonsteroidal anti-inflammatory drugs (NSAIDs) do not. Uninterrupted use of clopidogrel, a newer antiplatelet agent, is recommended in cardiac patients with drug-eluding stents.

The concern for most endoscopists is the potential increased risk of bleeding after therapeutic interventions, especially polypectomy, in patients whose coagulation status is impaired. The concern for the patient and his or her other treating physicians is the potential for thromboembolic events, which may pose a substantial, even life-threatening, risk to the patient whose anticoagulation
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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