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ΠΦΥ -Εκπαίδευση => Αποσπάσματα από τον έντυπο & ηλεκτρονικό τύπο => Μήνυμα ξεκίνησε από: Argirios Argiriou στις 14 Νοεμβρίου 2014, 10:05:01

Τίτλος: Κλοπιδογρέλη ή Κλοπιδογρέλη/Ασπιρίνη και εξαγωγή δοντιού.
Αποστολή από: Argirios Argiriou στις 14 Νοεμβρίου 2014, 10:05:01

Am J Cardiol. 2011 Oct 1;108(7):964-7. doi: 10.1016/j.amjcard.2011.05.029. Epub 2011 Jul 23.

Safety of dental extractions during uninterrupted single or dual antiplatelet treatment.

Author information

Lillis T1, Ziakas A, Koskinas K, Tsirlis A, Giannoglou G.

Abstract

Optimal dental management in patients on long-term antiplatelet treatment is not clearly defined. Antiplatelet discontinuation increases the risk of thrombotic complications, whereas uninterrupted antiplatelet therapy, which is the currently recommended approach, is assumed to increase the bleeding hazard after dental procedures. We sought to prospectively compare the risk of immediate and late postextraction bleeding in patients receiving uninterrupted single or dual antiplatelet therapy. We recruited 643 consecutive patients referred for dental extractions. In total 111 (17.3%) were on clinically indicated antiplatelet therapy: aspirin (n = 42), clopidogrel (n = 36), and aspirin and clopidogrel (n = 33). Controls (n = 532, 82.7%) were not on antiplatelet treatment. Immediate and late bleeding complications were recorded. Compared to controls the risk of prolonged immediate bleeding was higher in patients on dual antiplatelet therapy (relative risk [RR] 177.3, 95% confidence interval [CI] 43.5 to 722, p <0.001) but not in patients on aspirin alone (RR = 6.3, 95% CI 0.6 to 68.4, p = 0.2) or clopidogrel alone (RR = 7.4, 95% CI 0.7 to 79.5, p = 0.18); however, all immediate bleeding complications in all treatment groups were successfully managed with local hemostatic measures. No patient developed any late hemorrhage. In conclusion, dental extractions may be safely performed in patients receiving single or dual antiplatelet therapy when appropriate local hemostatic measures are taken, thus averting thrombotic risk of temporary antiplatelet discontinuation.

http://www.ncbi.nlm.nih.gov/pubmed/21784392

Τίτλος: Απ: Κλοπιδογρέλη ή Κλοπιδογρέλη/Ασπιρίνη και εξαγωγή δοντιού.
Αποστολή από: KΛ στις 14 Νοεμβρίου 2014, 11:44:40

Στο ίδιο συμπέρασμα κατέληγε και αυτό εδώ http://www.app.dundee.ac.uk/tuith/Static/info/antiplatelet.pdf
Είναι λίγο παλιό βέβαια ('Ελεγε οτι το επόμενο revision θα γινόταν το 2009. Δε βρήκα τίποτα όμως) αλλά πολύ κατατοπιστικό. Αναφέρει διάφορα ενδιαφέροντα στατιστικά σε σχέση επεισοδίων μετά από διακοπή αγωγής λόγω οδοντιατρικής επέμβασης

Τίτλος: Απ: Κλοπιδογρέλη ή Κλοπιδογρέλη/Ασπιρίνη και εξαγωγή δοντιού.
Αποστολή από: Argirios Argiriou στις 3 Απριλίου 2018, 22:59:53

Periprocedural management of oral anticoagulation: When and how to hit “pause”

J Fam Pract. 2018 April;67(4):210-216,219-222

https://www.mdedge.com/jfponline/article/161941/cardiology/periprocedural-management-oral-anticoagulation-when-and-how-hit (https://www.mdedge.com/jfponline/article/161941/cardiology/periprocedural-management-oral-anticoagulation-when-and-how-hit)