title: Safety of dental extractions in coronary drug-eluting stenting patients without stopping multiple antiplatelet agents.
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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, South Korea.
authors.forename: Mahn-Won
authors.initials: MW
authors.lastname: Park
authors.forename: Sung-Ho
authors.initials: SH
authors.lastname: Her
authors.forename: Jong Bum
authors.initials: JB
authors.lastname: Kwon
authors.forename: Jae Beom
authors.initials: JB
authors.lastname: Lee
authors.forename: Min-Seok
authors.initials: MS
authors.lastname: Choi
authors.forename: Jung Sun
authors.initials: JS
authors.lastname: Cho
authors.forename: Dong-Bin
authors.initials: DB
authors.lastname: Kim
authors.forename: Wook-Sung
authors.initials: WS
authors.lastname: Chung
authors.forename: Ki-Bae
authors.initials: KB
authors.lastname: Seung
authors.forename: Keon-Yeop
authors.initials: KY
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D054855:Drug-Eluting Stents / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology / Q000628:therapy*; D005791:Patient Care; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D057216:Propensity Score; D011446:Prospective Studies; D012307:Risk Factors; D012449:Safety; D013923:Thromboembolism / Q000139:chemically induced / Q000209:etiology*; D013997:Time Factors
chemical_list: D010975:Platelet Aggregation Inhibitors