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Study about Dental Extraction of Patients Receiving Antiplatelet Treatment
유태민 대한구강악안면병리학회 2012 대한구강악안면병리학회지 Vol.36 No.5
The population of patients with antiplatelet treatment is expanding globally with the rising prevalence of cardiovascular disease and increasing use of percutaneous coronoary interventions. While antiplatelet agents have revolutionized the management of atherosclerotic disease and its thromotic complications, the potential of bleeding remains an inherent risk. Dentists are more likely to stop antiplatelet therapy before dental extraction because they think that the patient is at high risk for bleeding. However stopping or altering antiplatelet therapy may expose such patients to the risk of a thromboembolic event such as thromboembolism, myocardial infarction, or cerebrovascular accidents particulary in patients wirh drug-eluting stent. In this study,we report 3cases that were perfomed dental extraction in patients receiving single or dual antiplatelet therapy without immediate and late postextraction bleeding and reviewed the literature on dental extraction in patients receiving antiplatelet therapy. We concluded that dental extractions may be safely performed in patients receiving single or dual antiplatelet therapy when appropriate local hemostatic measures are taken, thus averting thrombotic risk of temporary antiplatelet discontinuation.
유태민 대한구강악안면병리학회 2012 대한구강악안면병리학회지 Vol.36 No.5
The population of patients with antiplatelet treatment is expanding globally with the rising prevalence of cardiovascular disease and increasing use of percutaneous coronoary interventions. While antiplatelet agents have revolutionized the management of atherosclerotic disease and its thromotic complications, the potential of bleeding remains an inherent risk. Dentists are more likely to stop antiplatelet therapy before dental extraction because they think that the patient is at high risk for bleeding. However stopping or altering antiplatelet therapy may expose such patients to the risk of a thromboembolic event such as thromboembolism, myocardial infarction, or cerebrovascular accidents particulary in patients wirh drug-eluting stent. In this study, we report 3cases that were perfomed dental extraction in patients receiving single or dual antiplatelet therapy without immediate and late postextraction bleeding and reviewed the literature on dental extraction in patients receiving antiplatelet therapy. We concluded that dental extractions may be safely performed in patients receiving single or dual antiplatelet therapy when appropriate local hemostatic measures are taken, thus averting thrombotic risk of temporary antiplatelet discontinuation
Kim, Keunyoung,Bae, Ok-Nam,Koh, Sung-Hee,Kang, Seojin,Lim, Kyung-Min,Noh, Ji-Yoon,Shin, Sue,Kim, Inho,Chung, Jin-Ho ACADEMIC PRESS 2015 TOXICOLOGICAL SCIENCES Vol.147 No.2
<P>Potential risk of high-dose vitamin C consumption is often ignored. Recently, gram-dose vitamin C is being intravenously injected for the treatment of cancer, which can expose circulating blood cells to extremely high concentrations of vitamin C. As well as platelets, red blood cells (RBCs) can actively participate in thrombosis through procoagulant activation. Here, we examined the procoagulant and prothrombotic risks associated with the intravenous injection of gram-dose vitamin C. Vitamin C (0.5–5 mM) increased procoagulant activity of freshly isolated human RBCs via the externalization of phosphatidylserine (PS) to outer cellular membrane and the formation of PS-bearing microvesicles. PS exposure was induced by the dysregulation of key enzymes for the maintenance of membrane phospholipid asymmetry, which was from vitamin C-induced oxidative stress, and resultant disruption of calcium and thiol homeostasis. Indeed, the intravenous injection of vitamin C (0.5–1.0 g/kg) in rats <I>in vivo</I> significantly increased thrombosis. Notably, the prothrombotic effects of vitamin C were more prominent in RBCs isolated from cancer patients, who are at increased risks of thrombotic events. Vitamin C-induced procoagulant and prothrombotic activation of RBCs, and increased thrombosis <I>in vivo</I>. RBCs from cancer patients exhibited increased sensitivity to the prothrombotic effects of vitamin C, reflecting that intravenous gram-dose vitamin C therapy needs to be carefully revisited.</P>