This article is more than 5 years old. Information may no longer be current.
Clopidogrel not associated with excessive post-polypectomy bleeding
Click Here to Manage Email Alerts
Digestive Disease Week 2011
Patients assigned to clopidogrel before elective colonoscopy had similar rates of post-polypectomy bleeding as patients who did not receive the antiplatelet drug, according to results presented at Digestive Disease Week 2011.
These findings suggest that the cardiovascular risks of routinely discontinuing clopidogrel (Plavix, Sanofi-Aventis) before elective colonoscopy may exceed the risk for post-polypectomy bleeding, said Linda A. Feagins, MD, assistant professor of medicine at the University of Texas Southwestern Medical Center and the Dallas Veterans Affairs Medical Center.
Physicians at the Dallas VA do not routinely discontinue clopidogrel before colonoscopy because the institution has determined that the cardiovascular risks of doing so are greater than the risks for post-polypectomy bleeding. To test that policy, researchers performed a single center, retrospective case-control study of all 1,967 patients who underwent colonoscopic polypectomy from July 2008 to December 2009.
Researchers next compared the frequency of delayed post-polypectomy bleeding — defined as rectal bleeding within 30 days of polypectomy and repeat colonoscopy confirming bleeding from a polypectomy site — for patients assigned to clopidogrel (n=118) with those who were not (n=1,849).
“There was only one patient in the clopidogrel group who had delayed post-polypectomy bleeding compared with six post-polypectomy bleeds in the control group,” Feagins said. “In other words, the rate of bleeding after polypectomy was essentially the same in the populations who took clopidogrel and those who didn’t. These findings held up even after we used a technique called propensity matching to match patients in the clopidogrel group with patients in the control group based on the presence of other diseases, like kidney disease, that might increase the risk for bleeding after removal of polyps.”
The delayed post-polypectomy bleeding rate was 0.8% for the clopidogrel group vs. 0.3% for nonusers (unadjusted OR=2.63, 95% CI, 0.31-22.0). Matched analyses also showed no significant difference in bleeding rates between clopidogrel users and nonusers (0.9% vs. 0%).
Researchers observed significant differences between clopidogrel users and nonusers in the frequency of coronary artery disease (94.1% vs. 24.2%), aspirin use (78% vs. 27.9%), age (64.9 vs. 62.4) and lung disease (24.6% vs. 13.4%). – by Jason Harris
For more information:
- Uddin FS. #528. Presented at: Digestive Disease Week 2011; May 7-10, 2011; Chicago.
 |
Follow HemOncToday.com on Twitter. |