Blood thinners and gastrointestinal endoscopy

Table 2 Summary of recommendations for emergency endoscopic procedures

	Anticoagulant	APA
Active GI bleed	Hold the anticoagulant	Do not stop thienopyridines without discussion with the
	If on warfarin, give FFP, 4-factor PCC or IV Vitamin K to improve INR	cardiologist in high risk situations like within 3 mo of ACS,
	Avoid vitamin K in case of mechanical heart valve	within 1 mo of placing a bare metal coronary stent and within
	Hemodialysis in case of Dabigatran	12 mo of placing a drug eluting coronary stent
	Endoscopic therapy when INR is less than 2.5

APA: Antiplatelet agents; PCC: Prothrombin complex; ACS: Acute coronary syndrome; GI: Gastrointestinal; FFP: Fresh frozen plasma; INR: International normalized ratio; IV: Intravenous injection.