Antiplatelet therapy in patients with atherosclerotic coronary artery disease undergoing elective endoscopic gastrointestinal procedures. Key messages for clinical practice
Bibliographic record
Abstract
Should we interrupt antiplatelet therapy (acetylsalicylic acid [ASA] alone or in combination with clopidogrel) in patients with atherosclerotic coronary artery disease undergoing elective endoscopic gastrointestinal (GI) procedures? The relevant evidence was critically appraised in a recent White Paper from the American College of Gastroenterology and the American College of Cardiology. Clinicians need to qualify and compare 2 competing risks: the increased risk of bleeding if antiplatelet therapy is maintained during the endoscopic GI procedure, vs. the increased risk of cardiovascular (CV) thrombosis if antiplatelet therapy is interrupted or modified in the periprocedural period. ASA treatment may be continued for all endoscopic GI procedures, provided that there is no pre-existing bleeding disorder. Clopidogrel administration could be maintained for low-risk endoscopic GI procedures, such as diagnostic endoscopy of the upper or lower GI tract with or without biopsies. For patients on clopidogrel undergoing high-risk endoscopic GI procedures, such as polypectomy or sphincterotomy, the individualized risk of CV complications from clopidogrel discontinuation should be assessed. During the first month following bare-metal stent implantation or the first 6 (possibly 12) months following drug-eluting stent placement the CV risk is particularly high, therefore elective high-risk endoscopic GI procedures should be deferred accordingly. In all other clinical situations requiring clopidogrel treatment, the risk of CV events is lower than above. Therefore, clopidogrel treatment could be interrupted for 7 to 10 days before the procedure (and restarted as soon as possible after the procedure), provided that ASA treatment is maintained.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".