Polypectomy in Patients Taking Dual Antiplatelet Agents

Incheon St.Mary's Hospital

Status: Unknown

Conditions: Colonic Polyps

Treatments: Drug: Continue thienopyridine; Drug: Discontinue thienopyridine

Study type: Interventional

Funder types: Other

Identifiers

NCT02865824

CMC

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 180 estimated patients

Sex: All

Ages: 20 to 80 years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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180 participants in 2 patient groups

Continue thienopyridine

Active Comparator group

Description:

Patients continue dual antiplatelet therapy (DAT) before colonoscopy and all polyps are removed by cold snare polypectomy.

Treatment:

Drug: Continue thienopyridine

Discontinue thienopyridine

Experimental group

Description:

Patients discontinue thienopyridines for 1 week before colonoscopy and all polyps are removed by cold snare polypectomy.

Treatment:

Drug: Discontinue thienopyridine