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International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing
Seung Joo Kang1, Chung Hyun Tae2, Chang Seok Bang3
1Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
Insights
Updated guidelines help manage patients on antithrombotic agents during endoscopy. These recommendations address new evidence for antiplatelet agents and anticoagulants, aiding clinical decisions.
Area of Science:
- Gastroenterology
- Cardiology
- Clinical Practice Guidelines
Background:
- Antithrombotic agents are increasingly used in Korea due to rising cardiocerebrovascular disease and an aging population.
- Managing patients on these agents during endoscopic procedures presents a clinical challenge.
- Previous Korean guidelines (2020) require updating due to new evidence and international revisions.
Purpose of the Study:
- To revise and update clinical practice guidelines for managing patients on antithrombotic agents undergoing endoscopic procedures.
- To incorporate recent evidence on dual antiplatelet therapy and direct anticoagulant management.
- To provide expert consensus-based recommendations for endoscopists.
Main Methods:
- Revision of existing guidelines based on new evidence.
- Inclusion of international expert consensus and multidisciplinary review.
- Application of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology.
- Development of 14 specific recommendations.
Main Results:
- The revised guidelines incorporate updated evidence on antithrombotic therapy management.
- Recommendations address diagnostic and elective therapeutic endoscopy scenarios.
- The guideline was developed through a consensus process involving cardiologists and international experts.
Conclusions:
- These revised guidelines offer crucial information for endoscopists managing patients on antithrombotic agents.
- The recommendations aim to improve patient care and safety during endoscopic interventions.
- The guidelines will be periodically updated to reflect advancements in technology and evidence.
Abstract:
Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.
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