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

therapy is interrupted. Data on the actual risk of the occurrence of these events are limited, particularly for the risks of postpolypectomy bleeding.

"There are no data on the clopidogrel-associated risk of PPB, and the benefit of holding clopidogrel 7 to 10 days before polypectomy remains unproven. At the Syracuse Veterans Affairs Medical Center, clopidogrel is not routinely held before colonoscopy and polypectomy," said study lead author Uma Murthy, MD, Syracuse Veterans Affairs Medical Center, New York. "This study elucidates the risk of bleeding in patients undergoing colonoscopic polypectomy on uninterrupted clopidogrel therapy. We found that the use of clopidogrel alone was not associated with higher rates of PPB, but the risk increased when clopidogrel was concomitantly used with aspirin or other NSAIDs."

Patients and Methods

This was a retrospective study of all patients who underwent a colonoscopy with or without a polypectomy on uninterrupted clopidogrel therapy between January 2002 and October 2007 at the Veterans Affairs Medical Center in Syracuse, New York. Electronic pharmacy records and current procedural terminology (CPT) codes identified patients receiving clopidogrel therapy at the time of colonoscopy during the study period. Group A (cases) included 142 patients who underwent polypectomy and 77 underwent colonoscopy without a polypectomy. Group B (controls) comprised 1,243 randomly selected patients during the same period who had undergone colonoscopic polypectomy but were not receiving clopidogrel therapy. Patients with acute gastrointestinal bleeding were excluded.

Demographics, clinical parameters, polyp characteristics, polypectomy techniques, and postpolypectomy events in the groups were compared by univariate analysis. Stepwise logistic regression analyses identified independent risk factors associated with PPB. There was no difference in polyp number per patient, location, adenoma detection rate,
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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