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

and polypectomy technique between groups A and B.

Results

Forty-six patients had PPB, 8 in group A and 38 in group B. Among the postpolypectomy bleeders, aspirin/NSAID use was significantly higher in patients taking clopidogrel (8/8 vs. 16/38 not on clopidogrel). The immediate (intraprocedural) bleeding rate was similar in the two groups (2.1 percent vs. 2.1 percent). Delayed (postprocedural) PPB rate was higher in the group taking clopidogrel (3.5 percent vs. 1.0 percent). Delayed bleeding of significance requiring hospitalization and transfusion/intervention was also higher in patients taking clopidogrel (2.1 percent vs. 0.4 percent). The length of hospital stay and interventions for PPB were comparable between the two groups. There was no mortality.

Univariate comparison between 46 PPB cases and 1,339 nonbleeders showed that patients with PPB were older and had more polyps removed. Use of clopidogrel alone or aspirin/NSAIDs alone was comparable between PPB patients and nonbleeders, however, the concomitant use of clopidogrel and aspirin/NSAID was significantly higher among PPB patients. Concomitant use of clopidogrel and aspirin/other NSAIDs and the number of polyps removed were the only significant risk factors associated with PPB. Clopidogrel alone was not an independent risk factor for PPB.

Researchers concluded that the postpolypectomy bleeding rate is significantly higher in patients undergoing polypectomy while taking clopidogrel and concomitant aspirin/nonsteroidal anti-inflammatory drugs, but the risk is small and the outcome is favorable. Routine cessation of clopidogrel in patients before colonoscopy polypectomy is not necessary. This is the first study to show that in patients taking clopidogrel, PPB did not occur without concomitant aspirin/NSAID use.

Researchers further noted that stopping clopidogrel in individuals with cardiovascular and atherothrombotic diseases predisposes them to the serious r
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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