title: Correlation between International Normalized Ratio values and sufficiency of two different local hemostatic measures in anticoagulated patients.
abstract: OBJECTIVE
  The management of patients receiving oral anticoagulant therapy (OAT) undergoing minor oral surgeries is controversial. This study was designed to evaluate the correlation between International Normalized Ratio (INR) values and the sufficiency of two different local hemostatic measures in controlling postextraction bleeding in anticoagulated patients.
  
  
  METHODS
  One hundred and sixty patients receiving Warfarin OAT were included in this study. Patients were selected so that 80 patients have INR values of ≤2, whereas the remaining patients have the INR values ranging from 2 to 3. Forty patients were then randomly selected from each category to form two equal groups. Forty-five patients who had never been on OAT were selected as a negative control group (group 1). Failure to achieve hemostasis using a pressure pack was managed using either tranexamic acid (group 2) or Ankaferd Blood Stopper (ABS) (group 3).
  
  
  RESULTS
  The INR values of patients included in group 2 and 3 ranged from 1.5 to 3, with a mean of 2.2. No significant difference was recorded between the use of either tranexamic acid or ABS in achieving hemostasis in anticoagulated patients with INR values ranging between 2 and 3 (P = 0.93).
  
  
  CONCLUSIONS
  Based on our findings, ABS is a hemostatic agent of good efficacy. The effect of ABS in controlling post-extraction bleeding in anticoagulated patients with INR values ≤3 is comparable to tranexamic acid with no evidence to support the superiority of tranexamic acid over ABS.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Egypt.
authors.forename: Mohamed Zaghlool
authors.initials: MZ
authors.lastname: Amer
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Egypt.
authors.forename: Samah I
authors.initials: SI
authors.lastname: Mourad
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Egypt.|OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Belgium.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: Salem
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Egypt.
authors.forename: Ehab
authors.initials: E
authors.lastname: Abdelfadil
keywords: Gel foam; ankaferd; postextraction bleeding; tranexamic acid; warfarin