title: Bleeding Rate After Tooth Extraction in Patients Under Oral Anticoagulant Therapy.
abstract: OBJECTIVE
  The aim of this single-cohort prospective study was to evaluate the risk of adverse outcomes after tooth extraction in patients suffering from cardiovascular disorders and under oral anticoagulant therapy with an international normalized ratio within the value of 3.0.
  
  
  METHODS
  Two hundred ninety-three patients (mean age of 58.7 years) were enrolled and 560 tooth extractions were performed. Fresh extraction sockets were treated with collagen tablets and sutures. The risk of increased bleeding rate was evaluated for type of drug therapy (acenocoumarol or warfarin), type of cardiovascular diseases, and number of tooth extractions. Level of significance was set at 0.05.
  
  
  RESULTS
  The overall bleeding event rate was 6.8%. Among patients who had bleeding events, 4 suffered from valvular disorders, whereas 11 suffered from arrhythmias (8) or cardiomyopathies (3). The remaining 5 patients had a history of cardiomyopathy and arrhythmia.The bleeding events in patients who had more than 2 tooth extractions were significantly higher than those observed in patients who had only 1 tooth extraction (P <0.05).
  
  
  CONCLUSIONS
  Patients who received more than 2 tooth extractions, who were under treatment with acenocoumarol, and who suffered from multiple cardiovascular diseases were at high risk for bleeding events.
authors.affiliation: *Ambulatory Oral Surgery and Implantology, Torun †Department and Clinic of the Histology and Embriology, Zabrze-Rokitnica, Silesian University of Medicine, Katowice, Poland ‡Tuscan Stomatologic Institute, Versilia General Hospital, Lido di Camaiore (LU), Italy §Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa ||Free practice in Francavilla Fontana ¶Department of Surgical Sciences, Dental and Maxillofacial Department, University of Verona, Verona, Italy.
authors.forename: Damian
authors.initials: D
authors.lastname: Dudek
authors.forename: Saverio
authors.initials: S
authors.lastname: Marchionni
authors.forename: Mario
authors.initials: M
authors.lastname: Gabriele
authors.forename: Antonio
authors.initials: A
authors.lastname: Iurlaro
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Helewski
authors.forename: Paolo
authors.initials: P
authors.lastname: Toti
authors.forename: Federico
authors.initials: F
authors.lastname: Gelpi
authors.forename: Dario
authors.initials: D
authors.lastname: Bertossi
authors.forename: Antonio
authors.initials: A
authors.lastname: Barone
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D019106:Postoperative Hemorrhage / Q000139:chemically induced / Q000453:epidemiology*; D011446:Prospective Studies; D013537:Sutures / Q000009:adverse effects; D014081:Tooth Extraction / Q000009:adverse effects*; D014859:Warfarin / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin