Antithrombotic Management of Stroke Patients Before Colonoscopy
| Autor: | Veronica Kemerko Sesi, Brian Silver, Arun Chandok, Renzo Figari, Basel Assaad, Ann Silverman, Nithin Thummala, Lonni Schultz, Mohammed Rehman |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Myocardial Infarction Colonoscopy Hemorrhage Risk Assessment Drug Administration Schedule Fibrinolytic Agents Recurrence Risk Factors Internal medicine Antithrombotic medicine Humans Myocardial infarction Adverse effect Stroke Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Rehabilitation Retrospective cohort study Venous Thromboembolism Middle Aged medicine.disease Surgery Discontinuation Ischemic Attack Transient Female Neurology (clinical) Cardiology and Cardiovascular Medicine business Fibrinolytic agent |
| Zdroj: | Journal of Stroke and Cerebrovascular Diseases. 22:733-736 |
| ISSN: | 1052-3057 |
| Popis: | Background: Uncertainty exists regarding the management of antithrombotic medications in ischemic stroke and transient ischemic attack (TIA) patients around the time of colonoscopy. We sought to evaluate whether there was a difference in adverse events among patients who continued medications and those who had temporary discontinuation. Methods: Using a hospital administrative database, electronic charts of patients with a diagnostic code for stroke or TIA and a procedural codeforcolonoscopy werereviewed.Informationcollected includedbaseline demographics, medical history, and antithrombotic medications. Outcome measureswere stroke (ischemic and hemorrhagic), myocardial infarction, venous thromboembolism, and major systemic bleeding (i.e., requiring transfusion) up to 4 weeks after the procedure among patients who had medications continued versus temporarily discontinued. Results: One hundred seventy-seven patients met inclusion criteria. Antithrombotic medication was temporarily discontinued in 42 patients and continuedin135patients.Comparingpatientswhohadmedicationsheldtothosewhohad medications continued, stroke occurred in 1 (2.4%) versus 0 (0%; P 5.237) patients; myocardial infarction in no patients in either group; venous thromboembolism in 0 (0%) versus 1 (0.7%; P ..99) patients; and major system bleeding in 2 (4.8%) versus 4 (3.0%; P 5.628) patients. Conclusions: In this retrospective analysis, there was no significant difference in the occurrence of stroke, myocardial infarction, venous thromboembolism, and major bleeding between patients who had medications continued around the time of colonoscopy versus those who had temporary discontinuation. A prospective, randomized controlled study is warranted to further |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect