Abstract 14190: Optimal Peri-endoscopic Management of Anti-thrombotic Therapy in Chinese Elderly Patients: A Retrospective Study
Introduction: To investigate optimal timing of cessation and resumption of anti-thrombotic therapy (ATT) during gastrointestinal endoscopy in Chinese elderly patients.
Methods: Between January 1st 2008 and December 31st 2014,at Chinese PLA General Hospital, 3747 patients (76.03±10.3 years) hospitalized for elective gastrointestinal endoscopy were retrospectively analyzed. The study population were predominately male(96.1%) and senile(age ≥60, 92.3%).Patients‘ peri-endoscopic management of ATT and adverse events (thromboembolism and bleeding) were recorded. RхC tables were used to compare the differences of peri-endoscopic adverse events among patients with different peri-endoscopic management of ATT.
Results: the peri-endoscopic thromboembolic incidence in those with discontinuing ATT ≥7 days before procedure was significantly higher (8.12%). No difference of bleeding incidence was found among different cessation time before procedure. The peri-endoscopic thromboembolic incidence increased as the delaying of resuming ATT after procedure. However, the incidence of peri-endoscopic bleeding in patients with resuming ATT 2-7 days after procedure was lowest (0.63%). The reason why bleeding incidences in patients with resuming ATT >7 days, and those without resuming ATT were much higher than those with resuming ATT 2-7 days was that occurrence of bleeding urged physician to postpone or cancel resumption of ATT. When discontinuing ATT, the differences of peri-endoscopic thromboembolic or bleeding events between patients receiving low-molecular-weight heparin bridging therapy and those without bridging therapy were not significant.
Conclusions: Cessation of ATT <7 days before endoscopic procedure and resumption of ATT in 2-7days after procedure were optimal peri-endoscopic ATT management strategy for Chinese elderly patients.Bridging therapy couldn’t protect elderly patients from peri-endoscopic thromboembolic events.
Author Disclosures: H. Wang: None. T. Tao: None. H. Wang: None. Y. Guo: None. Y. Wang: None.
- © 2015 by American Heart Association, Inc.