[MANAGEMENT OF ANTICOAGULANT AND ANTIPLATELET THERAPY IN PATIENTS UNDERGOING PLANNED ENDOSCOPIC PROCEDURES]

Area of Science:

• Cardiology
• Gastroenterology
• Pharmacology

Background:

• Antithrombotic and antiplatelet therapies are crucial for preventing cardiovascular events.
• Hemorrhage is a significant complication, particularly during invasive procedures like endoscopy.
• Various anticoagulants and antiplatelet agents necessitate individualized peri-procedural management strategies.

Purpose of the Study:

• To provide recommendations for managing patients on antithrombotic or antiplatelet therapy undergoing elective gastrointestinal endoscopic procedures.
• To outline approaches for stratifying bleeding and thromboembolic risks.
• To guide clinicians in optimizing patient care during endoscopic interventions.

Main Methods:

• This review synthesizes current literature and guidelines on antithrombotic/antiplatelet drug management.
• It focuses on risk assessment for bleeding during endoscopy and thromboembolic events upon drug interruption.
• General recommendations and approaches are presented for peri-procedural care.

Main Results:

• Gastrointestinal endoscopic procedures carry a notable bleeding risk (≥1.5%) in patients on antithrombotic/antiplatelet therapy.
• A careful balance is required between the risk of procedural bleeding and the risk of thromboembolism if therapy is discontinued.
• Individualized risk stratification is essential for safe management.

Conclusions:

• Patients undergoing elective gastrointestinal endoscopy while on antithrombotic or antiplatelet drugs require careful pre-procedural evaluation.
• Management strategies should aim to minimize bleeding complications while preventing thrombotic events.
• This review offers a framework for informed decision-making in this complex patient population.