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Bleeding risk with clopidogrel and percutaneous endoscopic gastrostomy

Umair Sohail1, Chela Harleen1, Amin O Mahdi1

  • 1Umair Sohail, Chela Harleen, Amin O Mahdi, Murtaza Arif, Matthew L Bechtold, Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO 65212, United States.

World Journal of Gastrointestinal Endoscopy
|September 14, 2016
PubMed

Insights

Recent clopidogrel use did not increase bleeding risk in patients undergoing percutaneous endoscopic gastrostomy (PEG). This study found no significant differences in bleeding complications between PEG patients with or without clopidogrel.

Area of Science:

  • Gastroenterology
  • Cardiology
  • Internal Medicine

Background:

  • Percutaneous endoscopic gastrostomy (PEG) is a common procedure.
  • Clopidogrel is an antiplatelet medication often used in patients with cardiovascular conditions.
  • The safety of PEG in patients recently using clopidogrel requires evaluation.

Purpose of the Study:

  • To compare the incidence of bleeding within 48 hours after percutaneous endoscopic gastrostomy (PEG) in patients who were taking clopidogrel versus those who were not.

Main Methods:

  • A retrospective, single-center study included adult patients who underwent PEG between January 2008 and January 2014.
  • Patients were divided into two groups: those taking clopidogrel within 5 days of PEG and those not taking clopidogrel within 5 days of PEG.
  • Bleeding outcomes, including hematochezia, melena, hematemesis, hemoglobin decrease, blood transfusions, and repeat endoscopy, were assessed within 48 hours post-procedure.

Main Results:

  • Out of 319 PEG patients, 33 were on clopidogrel and 286 were not.
  • No patients in either group experienced hematochezia, melena, or hematemesis within 48 hours of PEG.
  • There were no statistically significant differences between the clopidogrel and non-clopidogrel groups regarding hemoglobin decrease (> 2 g/dL), blood transfusions, or need for repeat endoscopy for bleeding.

Conclusions:

  • Recent use of clopidogrel is not associated with a significant increase in post-procedure bleeding complications after percutaneous endoscopic gastrostomy (PEG).
  • The findings suggest that PEG can be safely performed in patients recently treated with clopidogrel.
Abstract

Keywords:
AntiplateletsBleedingClopidogrelComplicationsPercutaneous endoscopic gastrostomy

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