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Journal of Maxillofacial and Oral Surgery

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01-03-2021 | Myocardial Infarction | Original Article

Clinical Post-operative Bleeding During Minor Oral Surgical Procedure and In Vitro Platelet Aggregation in Patients on Aspirin Therapy: Are they Coherent?

Authors: Surjit Singh, Saptarshi Mandal, Ankita Chugh, Surender Deora, Gaurav Jain, Md. Atik Khan, Vinay Kumar Chugh

Published in: Journal of Maxillofacial and Oral Surgery | Issue 1/2021

Abstract

Aim

The risk of excessive bleeding prompts physicians to discontinue aspirin in patients on low-dose, long-term therapy which in turn puts them at the risk from adverse cardiovascular and thrombotic events. Effect of low-dose aspirin therapy on platelet function was assessed using platelet aggregation method. The aim was to correlate the laboratory platelet function with cutaneous and clinical oral bleeding time (BT).

Materials and Methods

One hundred one patients were enrolled in this prospective trial and were allocated into two groups. Interventional or test group consisted of patients who were on aspirin therapy (75 mg/100 mg) for primary or secondary prevention of angina, myocardial infarction and stroke. Minor oral surgical procedure was performed in this group without discontinuing aspirin therapy. Control group consisted of healthy patients (under no medication) undergoing minor oral surgical procedure. Cutaneous and clinical oral BT were recorded in both the groups. Venous blood sample was drawn, and percentage platelet aggregation function was analysed using adenosine diphosphate (ADP) and arachidonic acid (AA) reagents. The percentage of platelet aggregation was then correlated with cutaneous and clinical oral BT.

Results

A significant decrease in percentage platelet aggregation using ADP (aspirin-74.7 21.39; control-89.2 13.70) and AA (aspirin-47.6 23.11; control-82.3 20.17) was observed. However, there were no significant difference in mean cutaneous BT (aspirin-1.5 0.65 min; control-1.6 0.71 min) and clinical oral BT (aspirin-5.0 2.48 min; control-4.8 2.60 min) in aspirin and control groups.

Conclusion

Majority of the minor oral surgical procedures can be carried out safely without discontinuing aspirin in patients on low-dose long-term therapy. This is possible because despite significant platelet aggregation evident in laboratory evaluation there is lack of its clinical corroboration owing to aspirin resistance.

Clinical Trial Registration

CTRI/2018/02/012055.

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Title: Clinical Post-operative Bleeding During Minor Oral Surgical Procedure and In Vitro Platelet Aggregation in Patients on Aspirin Therapy: Are they Coherent?
Authors: Surjit Singh
Saptarshi Mandal
Ankita Chugh
Surender Deora
Gaurav Jain
Md. Atik Khan
Vinay Kumar Chugh
Publication date: 01-03-2021
Publisher: Springer India
Keyword: Myocardial Infarction
Published in: Journal of Maxillofacial and Oral Surgery / Issue 1/2021
Print ISSN: 0972-8279
Electronic ISSN: 0974-942X
DOI: https://doi.org/10.1007/s12663-020-01438-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical Post-operative Bleeding During Minor Oral Surgical Procedure and In Vitro Platelet Aggregation in Patients on Aspirin Therapy: Are they Coherent?

Abstract

Aim

Materials and Methods

Results

Conclusion

Clinical Trial Registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aim

Materials and Methods

Results

Conclusion

Clinical Trial Registration

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