Chest
Original Research: INTERVENTIONAL PULMONOLOGYEffect of Routine Clopidogrel Use on Bleeding Complications After Transbronchial Biopsy in Humans
Section snippets
Materials and Methods
The study was approved by the Institutional Review Board, and all patients gave written informed consent to the bronchoscopy and biopsy procedures.
Results
The study was stopped after 6 months because the bleeding rates in the clopidogrel group were excessive. Until the time of the planned interim analysis, 604 eligible patients had agreed to participate in the study. Of these, 30 patients (5%) had used clopidogrel within 24 h of the bronchoscopy; all were using it daily and continued to do so after the biopsy. The most common reason for using clopidogrel was primary or secondary prevention of coronary heart disease and prevention of graft
Discussion
Pulmonologists frequently encounter patients who require transbronchial lung biopsy with flexible bronchoscopy and who are receiving antiplatelet drugs. We previously found that aspirin alone is not associated with an increase in bleeding complications from transbronchial lung biopsy and therefore does not need to be stopped before this procedure.
These data cannot be generalized to clopidogrel use because its mechanism of action differs from that of aspirin. The results in this trial were not
Conclusions
Routine clopidogrel use greatly increases the risk of bleeding after transbronchial lung biopsy and therefore should be discontinued before this procedure.
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