For patients on dual antiplatelet therapy after drug-eluting stent (DES) implantation, elective gastrointestinal (GI) endoscopy should be deferred for at least 6 months and up to 1 year if clinically acceptable, according to a white paper published in the December 8, 2009, issue of the Journal of the American College of Cardiology.

Beyond that straightforward recommendation, however, management of cardiac patients on antiplatelet therapy who are facing GI endoscopy can be a high-wire act for clinicians—one performed without a net of reliable evidence. In deciding whether and how to suspend medications, doctors must negotiate a narrow path between thrombotic risk on ....

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