Risk of post-polypectomy bleeding after endoscopic mucosal resection in patients receiving antiplatelet medication: comparison between the continue and hold groups

Aims We aimed to assess post-polypectomy bleeding (PPB) inpatients receiving antiplatelet agents and underwent EMR for various polyp sizes.

Methods Patients who underwent at least one EMR forpolypectomy and those who received aspirin or clopidogrel were included. We compared PPB between the antiplatelet hold group (stopped antiplatelet therapy at least 5 days before the procedure) and continue group (antiplatelet therapy was maintained or stopped within 5 days before the procedure) [1].

Results Among patients who underwent EMR, 305 took aspirin (hold group 257, continue group 48) and 77 took clopidogrel(hold group 66, continue group 11). The mean number of polyps was four, and the mean size was 8.6 mm. There was nodiference in the major PPB rate between the hold and continue groups among aspirin users (2.0% vs. 4.2%, P=0.30), but itwas signifcantly higher in the continue group than in the hold group among clopidogrel users (18.2% vs. 0%, P=0.02). Inpatient- and polyp-based logistic regression analysis of clopidogrel users, the number of EMRs (OR 2.12, 95% CI 1.16–3.88),polyp size (OR 1.26, 95% CI 1.06–1.49), and continuing clopidogrel (OR 9.75, 95% CI 1.99–47.64) were independent riskfactors for PPB.

Conclusions Continuous administration of antiplatelet agents was signifcantly associated with higher PPB in clopidogrel users, but not in aspirin users. Endoscopists should consider holding clopidogrel if the EMR includes polypectomy.

Publikationsverlauf

Artikel online veröffentlicht:
14. April 2023

• 1 Park DI. Risk of post-polypectomy bleeding after endoscopic mucosal resection in patients receiving antiplatelet medication: comparison between the continue and hold groups