3.8 Article

Bleeding After Dental Extraction in Patients Undergoing Percutaneous Coronary Intervention During Uninterrupted Single and Dual Antiplatelet Therapy

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SPRINGER INDIA
DOI: 10.1007/s12663-023-02036-w

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Aspirin; Clopidogrel; Tooth extraction; Antiplatelet drugs; Bleeding

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The study found that simple or complicated extraction of multiple teeth can be performed safely during the first year after percutaneous coronary intervention without interrupting antiplatelet therapy.
Purpose This study aimed to assess bleeding risk after exodontia in patients with recent percutaneous coronary intervention during uninterrupted single or dual antiplatelet therapy.Study design A total of 100 patients who had a history of percutaneous stent insertion during the past year candidate for extraction of teeth were included in the study. Fifty patients took aspirin 100mg (monotherapy group), and 50 patients took a combination of aspirin 100mg and clopidogrel 75mg (dual therapy group). After exodontia, the bleeding status was categorized as complete hemostasis, persistent bleeding, and delayed bleeding. Personal data, underlying diseases, number of teeth and roots extracted, and type of procedure required for exodontia were statistically analyzed.Results No significant difference was observed in the status of bleeding between the two groups regarding sex, age, underlying diseases, number of teeth and roots extracted, and type of procedure (p > 0.05). 39/50 (78%) of monotherapy patients and 32/50 (64%) of dual therapy patients achieved complete hemostasis. Persistent bleeding was noted in 11/50 (22%) of monotherapy participants, and 14/50 (28%) of dual therapy patients. Only 4/50 (8%) of dual therapy patients experienced delayed bleeding. However, these differences were not significant (p = 0.08). All persistent and delayed bleeding was easily controlled via local measures.Conclusion Simple or complicated extraction of multiple teeth can be performed safely during the first year after percutaneous coronary intervention without interruption of antiplatelet therapy.

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