Safety of dental extractions in coronary drug-eluting stenting patients without stopping multiple antiplatelet agents.
Clin Cardiol
; 35(4): 225-30, 2012 Apr.
Article
en En
| MEDLINE
| ID: mdl-22278596
ABSTRACT
BACKGROUND:
The risk of excessive bleeding prompts physicians to stop multiple antiplatelet agents before minor surgery, which puts coronary stenting patients at risk for adverse thrombotic events.HYPOTHESIS:
We hypothesized that most dental extractions can be carried out safely without stopping multiple antiplatelet agents.METHODS:
All dental extraction patients who had undergone coronary stenting and who were also on oral multiple antiplatelet agents therapy were enrolled. One hundred patients underwent dental procedures without stopping antiplatelet agents. All wounds were sutured and followed up at 24 hours, 1 week, and 1 month after the procedure. There were 2233 patients who had not taken oral antiplatelet agents from a health promotion center and had teeth extracted by the same method. After performing propensity-score matching for the entire population, a total of 100 matched pairs of patients were created. The primary outcome was a composite of excessive intraextraction blood loss, transfusion, and rehospitalization for bleeding, and the secondary outcome was a composite of death, nonfatal myocardial infarction, target lesion revascularization, and stent thrombosis within 1 month after the procedure.RESULTS:
There were 2 excessive intraextraction bleeding cases that continued at the extraction site for 4 and 5 hours, respectively, in the coronary stenting patients, and 1 excessive intraextraction bleeding case that continued for 3 hours in the control patients. There were no cases of transfusion, rehospitalization for bleeding, or major cardiovascular events for the 2 propensity-matched groups.CONCLUSIONS:
We found that most dental extractions in coronary stenting patients can be carried out safely without stopping multiple antiplatelet agents.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Tromboembolia
/
Inhibidores de Agregación Plaquetaria
/
Stents Liberadores de Fármacos
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Atención al Paciente
/
Hemorragia
/
Infarto del Miocardio
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Clin Cardiol
Año:
2012
Tipo del documento:
Article
País de afiliación:
Corea del Sur