ABSTRACT
Purpose: Acetylsalicylic acid (ASA) has been used for the primary and secondary prevention of cardiovascularevents. To reduce bleeding, the administration of ASA has traditionally been suspended before dentalprocedures; however, this suspension potentially increases the risk of thromboembolic events. The effect ofASA on the amount of bleeding that occurs during tooth extraction procedures is controversial, andperioperative guidelines recommend that ASA administration should not be altered for such procedures. Theaim of this study was to evaluate the amount of bleeding that occurs during the intraoperative period of toothextraction procedures in patients with coronary artery disease who are either undergoing acetylsalicylic acid(ASA) therapy or who have been instructed to suspend their ASA use.Patients and Methods: Sixty-three patients with coronary artery disease who required tooth extractionwere enrolled in this study. All patients were receiving 100 mg/d of ASA at the time of enrollment and wererandomly placed into 2 groups: group S, which was comprised of patients whose ASA therapy was suspended7 days before tooth extraction, and group NS, comprised of patients whose ASA therapy was unaltered. Aplatelet aggregation test was carried out on the day of the operation, and the amount of bleeding wasmeasured during the intraoperative period by means of aspirated blood collection. All the extractions wereperformed by the same surgeon, who was unaware of whether the patients ASA therapy had been suspended.Results: The mean ( SD) volume of bleeding was 12.10 9.37 mL for patients who underwent ASAtherapy suspension and 16.38 13.54 mL for those patients whose treatments were unaltered (P .151). Local hemostatic methods were sufficient to control bleeding, and there were no reportedepisodes of hemorrhaging during the intra- and postoperative periods...
