Delayed resumption of direct oral anticoagulants following outpatient colonoscopy was associated with higher thromboembolic risk without a reduction in gastrointestinal (GI) bleeding, according to a cohort study published in Clinical Gastroenterology and Hepatology.
Management of anticoagulation around colonoscopy remains a common clinical challenge. Temporary interruption reduces post-procedural bleeding risk, but prolonged interruption may increase the risk of stroke and other thromboembolic events, noted Lawrence Jun Leung, MD, MPH, and colleagues.
“Currently, little is known about the optimal timing for DOAC resumption after colonoscopy to minimize the risks of both gastrointestinal bleeding and thromboembolic events, and the lack of an evidence base has prevented several gastroenterology societies from offering recommendations on the timing of DOAC resumption following colonoscopy,” wrote Dr. Leung, of the Department of Gastroenterology, Kaiser Permanente San Francisco Medical Center, and fellow researchers.