PPT-Management of Anticoagulants & Antiplatelet Agents Pre and Post Endoscopy

Thomas Savides MD Professor of Clinical Medicine University of California San Diego Disclosures None Learning Objectives Accurately assess the risk of bleeding in patients on anticoagulants and antiplatelet agents before endoscopic procedures. The Stan dards of Practice Committee of the American Society for Gastrointestinal Endoscopy ASGE prepared this text In preparing this guideline a search of the medical literature was performed by using PubMed Additional references were obtained from The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy ASGE prepared this text In preparing this guideline a search of the medical liter ature was performed by using PubMed Additional refer ences were obtained fro Tx. : . Real-World Practice. In the US, ~800,000 AF patients are on concomitant OAC and antiplatelet tx. 1. Patients on chronic OAC with CAD are 7x more likely to receive concomitant antiplatelet tx. Antiplatelet Guidelines. HEART FAILURE. Working Group: . Alan D. Bell, MD, CCFP; James D. . Douketis. , MD, FRCP. Objectives. Interpret . the . Canadian Cardiovascular Society Guideline . recommendations . thrombotics. in patients undergoing GI endoscopy. Dr Osman . Mapkar. Gastroenterolgy. Unit . Jahra. Hospital. Antithrombotic therapy. Indications. AF. ACS. DVT. Hypercoagulable states. Endoprostheses. Fawaz Altuwaijri. ACEM trainee. Introduction. Characteristics . of novel . anticoagulants. Laboratory Testing. Reversal in the bleeding patient. Introduction. Prevalence . atrial fibrillation. . 3.03 million in 2005. thrombotics. in patients undergoing GI endoscopy. Dr Osman . Mapkar. Gastroenterolgy. Unit . Jahra. Hospital. Antithrombotic therapy. Indications. AF. ACS. DVT. Hypercoagulable states. Endoprostheses. Lessons . learned . & . a way forward . Dale Agner, MD. Faculty, Clarkson Family Medicine Residency. Nebraska Medicine, Omaha, NE. daagner@nebraskamed.com. dale.agner@gmail.com. GOALS FOR THIS AM. Thomas Savides, M.D.. Professor of Clinical Medicine. University of California, San Diego. Disclosures. None. Learning Objectives. Accurately assess the risk of bleeding in patients on anticoagulants and antiplatelet agents before endoscopic procedures. Management of Anticoagulants & Antiplatelet Agents Pre and Post Endoscopy Thomas Savides, M.D. Professor of Clinical Medicine University of California, San Diego Disclosures None Learning Objectives What are Direct-Acting Oral Anticoagulants DOACsANSWERS by heartTreatments TestscontinuedAdhere to your medication regimen and do not abruptly stop taking your DOACs without 31rst talking with your d ?. That . major bleeding . occurs in about . 6.5% of patients on anticoagulants.. . That’s. . 1 patient in 15. . and commonly, GI Bleeding.. That . 1% . is . fatal bleeding . such as intracranial hemorrhage.. Anticoagulant therapy. (n = . 124). CADISS. P. rimary outcome. : . Ipsilateral . stroke or all-cause mortality . for antiplatelet vs. anticoagulation: 2. % . vs. 1%; p . = . 0.63. Any stroke: 2% vs. 1%, . intracerebral haemorrhage (ICH): extended follow-up of the. RE. start. or . ST. op. . A. ntithrombotics. . R. andomised . T. rial. (RESTART) . RESTART Collaboration. www.RESTARTtrial.org. Intracerebral haemorrhage (ICH) is associated with an increased risk of arterial ischaemic events*: pooled analysis of 4 population-based cohorts.