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Effect of Clopidogrel With and Without Aspirin on Bleeding Following Transbronchial Lung Biopsy^*

^* From the Department of Internal Medicine (Drs. Wahidi, Feller-Kopman, and Ernst, and Mr. Garland), Division of Pulmonary and Critical Care Medicine, Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and the Department of Endoscopy (Drs. Herth and Becker), ThoraxKlinik, Heidelberg, Germany.

Correspondence to: Momen M. Wahidi, MD, Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, 143-B Bell Building, Box 3683, Durham, NC 27710; e-mail: wahid001{at}mc.duke.edu

Background: Clopidogrel, a potent inhibitor of platelet aggregation, is being commonly prescribed in the elderly population due to its benefits in patients with atherosclerotic diseases. It is currently unknown whether clopidogrel increases the risk of bleeding during invasive pulmonary procedures.

Methods: Pigs of the Yorkshire species were randomized to one of the following two arms: clopidogrel (75 mg/d) alone; or clopidogrel plus aspirin (75 mg/d and 325 mg/d, respectively). The animals underwent flexible bronchoscopy with transbronchial lung biopsies under fluoroscopic guidance at baseline and after 1 week of daily oral intake of their assigned drugs. The main outcome of the study was the quantity of blood collected through the bronchoscope following transbronchial lung biopsy (TBLB).

Results: Sixteen animals were enrolled in the study, with 8 animals randomized to each arm. No statistically significant difference was found in the average quantity of blood resulting from transbronchial lung biopsies between procedures performed at baseline and those performed after animals received either clopidogrel (mean [± SD] dose, 1.41 ± 1.14 mL) or clopidogrel plus aspirin (mean dose, 1.75 ± 1.28 mL; p = 0.42).

Conclusions: Clopidogrel, with or without aspirin, does not increase bleeding complications after TBLB in healthy pigs.

Key Words: bronchoscopy • biopsy • clopidogrel • hemorrhage • swine

This article has been cited by other articles:

				A. Ernst, R. Eberhardt, M. Wahidi, H. D. Becker, and F. J. F. Herth Effect of Routine Clopidogrel Use on Bleeding Complications After Transbronchial Biopsy in Humans Chest, March 1, 2006; 129(3): 734 - 737. [Abstract] [Full Text] [PDF]

				K. Chinsky Bleeding Risk and Bronchoscopy: In Search of the Evidence in Evidence-Based Medicine Chest, June 1, 2005; 127(6): 1875 - 1877. [Full Text] [PDF]