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Is it safe to continue antithrombotic agents before prostate biopsy?

Kuniaki Tanabe1, Tomotaka Hattori2, Hirohito Kobayashi2

  • 1Department of Urology, Nippon Medical School, Tokyo, Japan.

Prostate International
|August 7, 2019
PubMed

Insights

Continuing antithrombotic agents before prostate biopsy increases bleeding complications. Patients taking these medications experienced more severe hemorrhagic events requiring intervention, highlighting the need for careful consideration.

Area of Science:

  • Urology
  • Cardiology
  • Hematology

Background:

  • The management of antithrombotic agents before prostate biopsy remains unclear.
  • Bleeding complications after prostate biopsy are a concern for patient safety.

Purpose of the Study:

  • To investigate the impact of continuing antithrombotic agents on bleeding complications following prostate biopsy.
  • To compare the frequency and severity of bleeding events in patients taking and not taking antithrombotic agents.

Main Methods:

  • Retrospective analysis of 1817 transrectal ultrasound-guided prostate biopsies.
  • Patients were divided into control (no antithrombotics) and experimental (antithrombotics) groups.
  • Bleeding severity was graded using Common Terminology Criteria for Advanced Events version 4.0.

Main Results:

  • The frequency of Grade 2 or higher bleeding events was significantly higher in the experimental group (3.5%) compared to the control group (1.7%), with an odds ratio of 2.18 (P=0.039).
  • Grade 3 events occurred in 1.2% of the experimental group versus 0.5% of the control group.
  • No significant difference in Grade 1 bleeding events was observed between the groups.

Conclusions:

  • Continuation of antithrombotic agents is associated with an increased risk of hemorrhagic complications requiring intervention after prostate biopsy.
  • Healthcare providers should carefully consider the use of antithrombotic agents in patients undergoing prostate biopsy.
Abstract

Keywords:
AA, antithrombotic agentAC, anticoagulant agentAP, antiplatelet agentASA, acetylsalicylic acidAnticoagulantsBiopsyHemorrhageMAP, major antiplatelet agentOR, odds ratioPSA, prostate-specific agentPlatelet aggregation inhibitorsProstateRR, relative riskSD, standard deviationTE, thromboembolismTPV, total prostate volumeTRUS, transrectal ultrasound

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