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Temporary Interruption versus Continuation of Non-aspirin, Non-P2Y12 Antiplatelet Monotherapy for Delayed
Yutaka Okagawa1, Masanori Sato1,2, Masahiro Hirakawa1,3
1Division of Medical Oncology, Department of Internal MedicineSapporo Medical University School of MedicineSapporoHokkaido PrefectureJapan.
Endoscopy International Open
|June 29, 2026
Summary
Interrupting non-aspirin antiplatelet agents (APAs) for one day before endoscopic procedures did not reduce delayed post-polypectomy bleeding (DPPB). Routine discontinuation of these APAs may be unnecessary due to potential thromboembolic risks.
Area of Science:
- Gastroenterology
- Cardiology
- Clinical Endoscopy
Background:
- Current guidelines suggest interrupting non-aspirin antiplatelet agents (APAs) before high-bleeding-risk procedures, but evidence is limited.
- Comparative data on the impact of interrupting other APAs on post-polypectomy bleeding are lacking.
Purpose of the Study:
- To evaluate if a 1-day interruption of other APAs reduces delayed post-polypectomy bleeding (DPPB) after hot snare polypectomy (HSP) or endoscopic mucosal resection (EMR).
Main Methods:
- Retrospective multicenter cohort study of patients on monotherapy with other APAs undergoing colorectal HSP/EMR.
- Comparison between patients who interrupted and continued their APAs, utilizing propensity score matching (PSM) for analysis.
- Evaluation of DPPB rates, patient backgrounds, polyp characteristics, and prophylactic measures.
Main Results:
- After PSM, 192 matched pairs showed no significant difference in DPPB rates between the interruption (1.0%) and continuation (1.0%) groups.
- Baseline and procedural characteristics were balanced post-PSM.
- One thromboembolic event occurred in the interruption group, none in the continuation group.
Conclusions:
- One-day interruption of other APAs is not associated with a significant reduction in DPPB risk during HSP/EMR.
- Routine discontinuation of other APAs may not be necessary due to potential thromboembolic risks.
- Prospective studies are required to re-evaluate current guideline recommendations regarding APA interruption.
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