Key result
Continuing antithrombotic therapy during EGD biopsy did not significantly increase the risk of upper-GI bleeding within 30 days compared to controls not receiving antithrombotic therapy.
Why the study?
Does performing EGD biopsy without cessation of antithrombotic therapy increase the risk of upper-gastrointestinal bleeding compared to patients not on antithrombotic therapy?
Observational (n=540)
Yes
Does performing EGD biopsy without cessation of antithrombotic therapy increase the risk of upper-gastrointestinal bleeding compared to patients not on antithrombotic therapy?
Upper gastrointestinal endoscopic biopsy can be safely performed without interrupting antithrombotic therapy, as it does not increase the 30-day risk of bleeding.
Supports continuing antithrombotics for EGD biopsy without excess bleeding; hypothesis-generating and requires RCT confirmation before practice change.
BACKGROUND: Although antithrombotic agents are widely used for cardiac and cerebrovascular disease prevention, they increase the risk of gastrointestinal (GI) bleeding. OBJECTIVE: To examine GI bleeding risk in association with an esophagogastroduodenoscopy (EGD) biopsy performed in patients without cessation of antithrombotic therapy. METHODS: This study was prospectively conducted at 14 centers. EGD biopsies were performed in patients receiving antithrombotic agents without cessation, as well as age- and sex-matched controls not receiving antithrombotic therapy. Patients treated with warfarin before the biopsy had a prothrombin time-international normalized ratio level <3.0. The proportion of GI bleeding events was compared between the groups. RESULTS: The patient group (n = 277) underwent a total of 560 biopsies while continuing antithrombotic therapy, of whom 24 were receiving multiple antiplatelet drugs, and 9 were receiving both antiplatelet and anticoagulant agents. The control patients (n = 263) underwent 557 biopsies. The upper-GI bleeding rate within 30 days after the EGD biopsy did not increase in patients without cessation of antithrombotic treatment, regardless of receiving single or multiple antithrombotic agents. CONCLUSIONS: We found no significant increase in upper-GI bleeding risk following an EGD biopsy in patients taking antithrombotic agents, suggesting its safety without the need for antithrombotic treatment interruption.
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Yuki et al. (2017) conducted an observational in Patients undergoing esophagogastroduodenoscopy (EGD) biopsy (n=540). Antithrombotic therapy without cessation vs. Age- and sex-matched controls not receiving antithrombotic therapy was evaluated on Upper-GI bleeding rate within 30 days after EGD biopsy. Continuing antithrombotic therapy during EGD biopsy did not significantly increase the risk of upper-GI bleeding within 30 days compared to controls not receiving antithrombotic therapy.
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