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Heparin‐bridging therapy and risk of post‐polypectomy bleeding: Meta‐analysis of data reported by Japanese colonoscopists
Author(s) -
Jaruvongvanich Veeravich,
Assavapongpaiboon Buravej,
Wijarnpreecha Karn,
Ungprasert Patompong
Publication year - 2017
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12882
Subject(s) - medicine , polypectomy , meta analysis , heparin , bridging (networking) , gastroenterology , colonoscopy , computer network , colorectal cancer , cancer , computer science
Background and Aim Peri‐procedural bridging ( PPB ) with heparin is recommended for patients with high thromboembolic risk who need to withhold antithrombotic therapy for colonoscopic polypectomy. However, little is known about the bleeding risk from heparin‐bridging therapy itself. Methods MEDLINE and EMBASE databases were searched through January 2017 for studies that compared the risk of PPB in patients who received heparin‐bridging therapy in lieu of antithrombotic agents for colonoscopic polypectomy and those who discontinued antithrombotic agents without receiving heparin. Pooled odds ratio ( OR ) and 95% confidence interval ( CI ) were calculated using a random‐effects model, generic inverse variance method. Between‐study heterogeneity was quantified using the Q statistic and I 2 . Results A total of five studies consisting of 2601 patients were identified. A significantly increased risk of PPB among bridged patients compared to non‐bridged patients was demonstrated with a pooled OR of 8.29 (95% CI , 4.96–13.87). Statistical heterogeneity was low with I 2 of 0%. Conclusion The present study demonstrated a significantly increased risk of PPB among patients who underwent colonoscopic polypectomy and received heparin‐bridging therapy in lieu of antithrombotic agents compared to patients who did not receive it.