Anticoagulants and antiplatelet agents commonly are used to treat patients with cardiovascular and cerebrovascular diseases.
However, there is limited data on the safety of using these drugs before colonoscopic polypectomy.
In this study, researchers from Hong Kong, China, evaluated consecutive patients undergoing colonoscopy and polypectomy during a 2 year period.
The team used a hospital database to document patient demographics, site and size of polyps, and the use of anticoagulants and antiplatelet agents.
They classified any bleeding episodes as immediate or delayed and were graded as mild, moderate, or severe.
The risk factors associated with postendoscopy bleeding were then analyzed using multivariate logistic regression analysis.
|2% of patients experienced post-polypectomy bleeding.|
The research team examined 5593 cases. Of these, polypectomy was performed in 1657.
The team identified 37 cases of polypectomy-associated bleeding. The bleeding was found to be immediate in 32 patients and delayed in 5.
Using multivariate analysis, the researchers determined that warfarin use was an independent risk factor for bleeding (odds ratio 13.37).
Age, location and size of polyp, and the use of aspirin, NSAIDs, and other antiplatelet agents were not associated with a higher risk of bleeding.
Dr Aric Hui's team concluded, "The use of antiplatelet agents during polypectomy was not associated with an increase in post-polypectomy bleeding".
"In contrast, treatment with warfarin should be discontinued, because this was associated with a significant increase in post-polypectomy bleeding".