Key result
Discontinuation of antithrombotic therapy before colon polypectomy resulted in similar rates of immediate bleeding compared to patients not taking antithrombotics (3.9% vs 4.6%; OR 0.85; P=0.65).
Why the study?
Few studies have examined the incidence of post-polypectomy bleeding after discontinuation of antithrombotic therapies.
Does the discontinuation of antithrombotic therapy before colon polypectomy affect the incidence of post-polypectomy bleeding compared to patients not taking antithrombotics?
Cohort (n=1,930)
No
Does the discontinuation of antithrombotic therapy before colon polypectomy affect the incidence of post-polypectomy bleeding compared to patients not taking antithrombotics?
Odds Ratio: 0.85 (95% CI 0.42–1.72)
Absolute Event Rate: 3.9% vs 4.6%
p-value: p=0.65
Discontinuation of antithrombotic therapy before colon polypectomy using specific cessation periods resulted in similar bleeding rates compared to patients not taking antithrombotics, with no thromboembolic events.
May support temporary antithrombotic discontinuation before polypectomy; leaves open need for randomized confirmation of safety.
BACKGROUND/AIMS: Few studies have examined the incidence of post-polypectomy bleeding (PPB) after discontinuation of antithrombotic therapies. Therefore, this study aimed to evaluate the incidence of PPB and thromboembolic events in patients whose antithrombotic agents were discontinued before colonoscopy. MATERIALS AND METHODS: We retrospectively selected all patients who underwent colon polypectomy at a community hospital. A total of 282 patients (540 polypectomies) discontinued antithrombotic agents (group 1), and 1,648 patients (2,827 polypectomies) did not take antithrombotic agents (group 2). The cessation periods before and after polypectomies were 4 and 3 days for warfarin, 5 and 3 days for anti-platelet agents, and 7 and 5 days of combination therapy, respectively. Main outcome measurements were the incidence of PPB and thromboembolic events. RESULTS: Immediate PPB rates were 3.9% (11/282) in group 1 and 4.6% (76/1648) in group 2 (adjusted odds ratio [OR], 0.85; 95% confidence interval [CI], 0.42-1.72; p=0.65). Delayed PPB rates were 1.4% (4/282) in group 1 and 1.1% (18/1648) in group 2 (adjusted OR, 1.24; 95% CI, 0.36-4.24; p=0.732). No thromboembolic events were observed in either group. CONCLUSION: Our cessation periods were appropriate, and further shortening of these periods is possible.
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Kishino et al. (2020) conducted a cohort in Colon polypectomy (n=1,930). Discontinuation of antithrombotic therapy vs. No antithrombotic therapy was evaluated on Immediate post-polypectomy bleeding (OR 0.85, 95% CI 0.42-1.72, p=0.65). Discontinuation of antithrombotic therapy before colon polypectomy resulted in similar rates of immediate bleeding compared to patients not taking antithrombotics (3.9% vs 4.6%; OR 0.85; P=0.65).
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