ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2019
Patients Prescribed Direct-Acting Oral Anticoagulants Have Low Risk of Postpolypectomy Complications.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 24 citations in OpenAlex.
- International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy.Gut and liver · 2024Review
- A dynamic online nomogram for predicts delayed postoperative bleeding after colorectal polyp surgery.Scientific reports · 2024Article
- [IDEN Consensus on Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2024Review
- International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy.Clinical endoscopy · 2024Review
- Management of Antiplatelet and Anticoagulant Agents before and after Polypectomy.Gastrointestinal endoscopy clinics of North America · 2022Review
- Risk of delayed bleeding after hot snare polypectomy and endoscopic mucosal resection in the colorectum with continuation of anticoagulants.Journal of gastrointestinal oncology · 2021Article
- Incidence and risk factors of colorectal delayed post-polypectomy bleeding in patients taking antithrombotics.Journal of digestive diseases · 2021Article
- Is Submucosal Injection Helpful in Cold Snare Polypectomy for Small Colorectal Polyps?Clinical endoscopy · 2021Article
- Risk of postpolypectomy bleeding in patients taking direct oral anticoagulants or clopidogrel.Scientific reports · 2021Article
- Anticoagulation and antiplatelet management in gastrointestinal endoscopy: A review of current evidence.World journal of gastrointestinal endoscopy · 2020Review
- Management of antiplatelet or anticoagulant therapy in endoscopy: A review of literature.World journal of gastrointestinal endoscopy · 2020Review
- Multicenter Study of the Hemorrhage Risk after Endoscopic Mucosal Resection Associated with Direct Oral Anticoagulants.Gastroenterology research and practice · 2019Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsUse of direct-acting oral anticoagulants (DOACs) is increasing, but little is known about the associated risks in patients undergoing colonoscopy with polypectomy. We aimed to determine the risk of post-polypectomy complications in patients prescribed DOACs.
methodsWe performed a retrospective analysis using Optum's de-identified Clinformatics Data Mart Database (2003-2016) (a de-identified administrative database from a large national insurance provider) to identify adults who underwent colonoscopy with polypectomy or endoscopic mucosal resection (EMR) from January 1, 2011, through December 31, 2015. We collected data from 11,504 patients prescribed antithrombotic agents (1590 DOAC, 3471 warfarin, and 6443 clopidogrel) and 599,983 patients not prescribed antithrombotics of interest (controls). We compared 30-day post-polypectomy complications, including gastrointestinal bleeding (GIB), cerebrovascular accident (CVA), myocardial infarction (MI), and hospital admissions, of patients prescribed DOACs, warfarin, or clopidogrel vs controls.
resultsPost-polypectomy complications were uncommon but occurred in a significantly higher proportion of patients receiving any antithrombotic vs controls (P < .001). The percentage of patients in the DOAC group with GIB was 0.63% (95% CI, 0.3%-1.2%) vs 0.2% (95% CI, 0.2%-0.3%) in controls. The percentage of patients with CVA in the DOAC group was 0.06% (95% CI, 0.01%-0.35%) vs 0.04% (95% CI, 0.04%-0.05%) in controls. After we adjusted for bridge anticoagulation, EMR, Charlson comorbidity index (CCI), and CHADS
conclusionIn our retrospective analysis of a large national dataset, we found that patients prescribed DOACs did not have significantly increased adjusted odds of post-polypectomy GIB, MI, CVA, or hospital admission. Bridge anticoagulation, higher CHADS
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