Key result
Heparin bridge therapy was associated with a significantly higher incidence of post-polypectomy bleeding (13.0% vs 5.7%, P=0.0038) compared to temporary cessation of all anticoagulants.
Why the study?
The incidence of post-polypectomy bleeding specifically in patients on anticoagulants was less well defined.
Does a heparin bridge increase post-polypectomy bleeding and emergency department visits among anticoagulated patients?
Cohort (n=662)
No
Does a heparin bridge increase post-polypectomy bleeding and emergency department visits among anticoagulated patients?
Absolute Event Rate: 13% vs 5.7%
p-value: p=0.0038
Heparin bridging is associated with increased post-polypectomy bleeding and emergency department visits in anticoagulated patients.
May warrant avoiding heparin bridging before polypectomy; leaves open confirmation in randomized trials.
Colonoscopy remains the preferred method for prevention of colorectal cancer, serving as both a screening and a therapeutic modality. With an estimated 22.4 million colonoscopies performed annually in the United States and another 11 million individuals estimated to be taking anticoagulant therapy, gastroenterologists will increasingly need to be familiar with these medications and understand the associated adverse events It is essential for clinicians to understand, and more importantly reduce, procedure-associated adverse events, including the most common post-polypectomy bleeding Reported to occur in approximately 0.3-10% of cases overall, the incidence of post-polypectomy bleeding related specifically to a population of patients on anticoagulants is less well defined
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Dionne Rebello (2019) conducted a cohort in Anticoagulated patients undergoing colonoscopy (n=662). Heparin bridge therapy (subcutaneous enoxaparin) vs. Temporary cessation of anticoagulants (no-bridge) was evaluated on Post-polypectomy bleeding (p=0.0038). Heparin bridge therapy was associated with a significantly higher incidence of post-polypectomy bleeding (13.0% vs 5.7%, P=0.0038) compared to temporary cessation of all anticoagulants.
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