Polypectomy in Patients Taking Dual Antiplatelet Agents

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

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

Conditions
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Colonic Polyps

Intervention / Treatment
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* Drug: Continue thienopyridine
* Drug: Discontinue thienopyridine


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Continue thienopyridine<br>Patients continue dual antiplatelet therapy (DAT) before colonoscopy and all polyps are removed by cold snare polypectomy. | Drug: Continue thienopyridine<br>* Patients continue dual antiplatelet therapies before colonoscopy. The patients continue taking thienopyridine before colonoscopy<br>* Other names: DAT group;|
| Experimental: Discontinue thienopyridine<br>Patients discontinue thienopyridines for 1 week before colonoscopy and all polyps are removed by cold snare polypectomy. | Drug: Discontinue thienopyridine<br>* Patients who are taking dual antiplatelet therapies stop thienopyridine one week before they undergo colonoscopy<br>* Other names: Aspirin group;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Delayed bleeding requiring hemostasis after polypectomy |  | 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| immediate bleeding requiring hemostasis after polypectomy |  | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Colonoscopy