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, according to the release. The study appears in the May issue of GIE: Gastrointestinal Endoscopy, ASGE’s monthly peer-reviewed scientific journal.
Historically, endoscopists have worried over the risk of bleeding after colonscopic polypectomy, which has a complication rate ranging from 0.3-3.6 percent. Aspirin and NSAIDs can reduce this risk, and clopidogrel has been recommended in cardiac patients with drug-eluding stents, according to the release.
Researchers evaluated 219 clopidogrel patients who underwent either polypectomy or colonoscopy without a polypectomy and 1,243 controls undergoing colonoscopic ploypectomy without clopdiogrel therapy.
Eight patients in the clopidogrel group and 38 in the control group reported postpolypectomy bleeding, and these patients were older and had more polyps removed than nonbleeders, according to the release. The number of polyps removed and concomitant use of clopidogrel and aspirin or NSAIDs were the only risk factors associated with postpolypectomy bleeding.
Researches concluded that although the risk of postpolypectomy bleeding was higher in patients undergoing the procedure and clopidogrel with aspirin/NSAIDs, the risk was small. They further suggested that patients defer screening colonoscopy for the first 6-12 months following coronary intervention.
Read the ASGE’s release on polypectomy in patients on clopidogrel therapy (pdf).
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