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Bleeding Risk Related to Upper Gastrointestinal Endoscopic Biopsy in Patients Receiving Antithrombotic Therapy: A

Takafumi Yuki1, Shunji Ishihara2, Kazuo Yashima3

  • 1Gastrointestinal Endoscopy, Shimane University Hospital, Izumo, Japan.

Current Therapeutic Research, Clinical and Experimental
|August 2, 2017
PubMed

Insights

Continuing antithrombotic therapy during esophagogastroduodenoscopy (EGD) biopsy is safe. This study found no increased gastrointestinal bleeding risk, even with multiple medications, supporting uninterrupted treatment.

Area of Science:

  • Gastroenterology
  • Cardiology
  • Pharmacology

Background:

  • Antithrombotic agents are crucial for preventing cardiovascular and cerebrovascular events.
  • These medications significantly increase the risk of gastrointestinal (GI) bleeding.
  • The safety of performing esophagogastroduodenoscopy (EGD) biopsies without stopping antithrombotic therapy is a critical clinical question.

Purpose of the Study:

  • To assess the risk of GI bleeding following EGD biopsy in patients who continue their antithrombotic therapy.
  • To compare bleeding rates between patients on antithrombotics and a control group not on these medications.

Main Methods:

  • A prospective study conducted across 14 centers.
  • EGD biopsies were performed on patients continuing antithrombotic agents and age/sex-matched controls.
  • Bleeding events within 30 days post-biopsy were compared between groups, with specific warfarin management (INR <3.0).

Main Results:

  • A total of 560 biopsies were performed on 277 patients continuing antithrombotic therapy (including dual antiplatelet and combined antiplatelet/anticoagulant regimens).
  • 557 biopsies were performed on 263 control patients.
  • No significant increase in upper-GI bleeding rates was observed in patients continuing antithrombotic treatment, irrespective of the number or type of agents used.

Conclusions:

  • Performing EGD biopsies is safe in patients maintained on antithrombotic agents.
  • Interruption of antithrombotic therapy is not necessary before EGD biopsy, simplifying patient management.
  • These findings support the continuation of antithrombotic therapy during EGD biopsy procedures.
Abstract

Keywords:
anticoagulant drugantiplatelet drugbiopsyesophagogastroduodenoscopygastrointestinal bleeding

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