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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 practice.
Area of Science:
- Gastroenterology and Cardiology
- Clinical Practice Guidelines
Background:
- Increasing incidence of cardiocerebrovascular disease and aging population in Korea drive antithrombotic agent use.
- Managing patients on antithrombotic agents during endoscopic procedures presents a clinical challenge.
- Previous Korean guidelines (2020) require updates 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 consensus-based recommendations for endoscopists.
Main Methods:
- Revision of previous guidelines based on new evidence and international standards.
- Inclusion of cardiologists and international experts in the guideline development process.
- Utilized the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology for 14 recommendations.
- Reviewed by multidisciplinary experts.
Main Results:
- Presents 14 revised recommendations for managing patients on antithrombotic therapy during endoscopy.
- Incorporates updated evidence on dual antiplatelet therapy and direct anticoagulants.
- Guidelines developed through consensus among international experts and reviewed by multidisciplinary teams.
Conclusions:
- The revised guidelines offer crucial information for endoscopists managing patients on antithrombotic agents.
- Aims to improve patient care during diagnostic and elective therapeutic endoscopy.
- Guidelines will be updated to reflect future changes in technology, evidence, and clinical practice.
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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