Bleeding after tooth extraction in patients taking aspirin and clopidogrel (Plavix®) compared with healthy controls

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• 作者：Mohsen Sadeghi-Ghahrody^a ; Seyed Hamid Yousefi-Malekshah^a ; Hamidreza Karimi-Sari^b ; ^{dr.karimih@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Hamid Yazdanpanah^a ; Mohammad Saeid Rezaee-Zavareh^b ; Mohammadhosein Yavarahmadi^b
• 关键词：Aspirin ; Clopidogrel ; Tooth extraction ; Uncontrolled bleeding
• 刊名：British Journal of Oral and Maxillofacial Surgery
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：54
• 期：5
• 页码：568-572
• 全文大小：347 K

文摘

The risk of perioperative bleeding is high in patients who take aspirin and clopidogrel after a percutaneous coronary intervention, and whether to stop the drugs is a matter of concern for dentists. The aim of this study was to answer the specific question: should aspirin and clopidogrel bisulphate (Plavix®) be discontinued during a conventional forceps extraction? We studied 64 patients during the first year after percutaneous insertion of coronary stents who were taking aspirin (ASA) 80 mg and clopidogrel (Plavix^®) 75 mg, and 50 healthy patients who were to have a conventional forceps extraction at this polyclinic in 2013-2014 and acted as controls. Clinical details (underlying diseases; number of roots; type of tooth; type of haemostasis; and bleeding immediately, 30 minutes, and 48 hours after intervention) were compared. We evaluated 114 patients with the mean (range) age of 56 (43–76) years, and there were no significant differences in demographic data, underlying diseases, type of tooth, number of roots, and dose of anaesthetic between the groups. There were also no significant differences in the number of bleeds immediately and 30 minutes after intervention (P = 0.310 and 0.205). The time that the last dose of aspirin had been taken correlated with 30-minute haemostasis (20 compared with 12 hours, p=0.037). During the 48 hours after the intervention, there were no uncontrolled bleeds or emergency referrals. We conclude that using aspirin and Plavix® simultaneously has no considerable effect on the risk of bleeding in patients having conventional forceps extraction of a single tooth.