Polypectomy in Patients Taking Dual Antiplatelet Agents

Effects of Antiplatelets Discontinuation in Patients Receiving Polypectomy: Randomized Controlled Trial

Current guidelines recommend discontinuation of antiplatelets (i.e clopidogrel) for 7 days in patients taking DAT (dual antiplatelet therapy) before colonoscopy and polypectomy. The purpose of this study was to examine if a) discontinuation of these drugs reduces bleeding risks during polypectomy and if b) discontinuation of these drugs increases the occurence of thromboembolic events.

Patients taking dual antiplatelets (DAT) and who visited for colonoscopy were eligible for enrollment in this study. On enrollment, patients were randomized to two groups. One group continued DAT and the other group discontinued antiplatelets (i.e. clopidogrel, ticagrelor, prasugrel) for 7 days before colonoscopy. If polyps (≤1 cm) were observed during colonoscopy, they were removed by cold snare polypectomy. The primary aim was to compared the delayed bleeding rates of the two groups.

Inclusion Criteria:

• patients over the age of 20 years undergoing routine colonoscopy
• patients who are taking DAT (dual antiplatelet therapy)

Exclusion Criteria:

• patients not abiding to the study protocol
• history of inflammatory bowel disease
• severe comorbidities
• American Society of Anesthesiology class III or more
• pregnancy