DATA SOURCES: PubMed, ScienceDirect and EBSCOhost databases. STUDY SELECTION: Prospective randomised controlled trials (RCTs) or controlled trials. DATA EXTRACTION AND SYNTHESIS: Two independent investigators extracted data. The primary measured outcomes were rates of haemorrhage and bleeding time. Disagreements were clarified with a third investigator. Relevant authors were contacted if any relevant data was missing. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system was used to evaluate the overall quality of evidence. The authors used standardised mean difference or relative risk to evaluate each outcome. RESULTS: Ten studies were included, three randomised controlled trials and seven controlled trials. A total of 1752 patients were enrolled in the meta-analysis; the study group comprised 529 patients on long-term aspirin therapy, and the control group comprised 1223 patients. The risk of post-operative haemorrhage was significantly higher in patients on aspirin therapy (relative risk=2.46; 95% confidence interval: 1.45-4.81) but bleeding time was not significantly different between the two groups (standardised mean difference=0.63; 95% CI: - 0.04 to 1.31). CONCLUSIONS: Increased rates of haemorrhage are observed in patients on long-term aspirin therapy. The authors recommend not stopping long-term aspirin prior to dental extraction, and local measures for haemostasis should be enhanced when required.
DATA SOURCES: PubMed, ScienceDirect and EBSCOhost databases. STUDY SELECTION: Prospective randomised controlled trials (RCTs) or controlled trials. DATA EXTRACTION AND SYNTHESIS: Two independent investigators extracted data. The primary measured outcomes were rates of haemorrhage and bleeding time. Disagreements were clarified with a third investigator. Relevant authors were contacted if any relevant data was missing. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system was used to evaluate the overall quality of evidence. The authors used standardised mean difference or relative risk to evaluate each outcome. RESULTS: Ten studies were included, three randomised controlled trials and seven controlled trials. A total of 1752 patients were enrolled in the meta-analysis; the study group comprised 529 patients on long-term aspirin therapy, and the control group comprised 1223 patients. The risk of post-operative haemorrhage was significantly higher in patients on aspirin therapy (relative risk=2.46; 95% confidence interval: 1.45-4.81) but bleeding time was not significantly different between the two groups (standardised mean difference=0.63; 95% CI: - 0.04 to 1.31). CONCLUSIONS: Increased rates of haemorrhage are observed in patients on long-term aspirin therapy. The authors recommend not stopping long-term aspirin prior to dental extraction, and local measures for haemostasis should be enhanced when required.
Authors: Danielle Menosi Gualandro; Pai Ching Yu; Bruno Caramelli; André Coelho Marques; Daniela Calderaro; Luciana Savoy Fornari; Claudio Pinho; Alina Coutinho Rodrigues Feitosa; Carisi Anne Polanczyk; Carlos Eduardo Rochitte; Carlos Jardim; Carolina L Z Vieira; Debora Y M Nakamura; Denise Iezzi; Dirk Schreen; Eduardo Leal Adam; Elbio Antonio D'Amico; Emerson Q de Lima; Emmanuel de Almeida Burdmann; Enrique Indalecio Pachón Mateo; Fabiana Goulart Marcondes Braga; Fabio S Machado; Flavio J de Paula; Gabriel Assis Lopes do Carmo; Gilson Soares Feitosa-Filho; Gustavo Faibischew Prado; Heno Ferreira Lopes; João R C Fernandes; José J G de Lima; Luciana Sacilotto; Luciano Ferreira Drager; Luciano Janussi Vacanti; Luis Eduardo Paim Rohde; Luis F L Prada; Luis Henrique Wolff Gowdak; Marcelo Luiz Campos Vieira; Maristela Camargo Monachini; Milena Frota Macatrão-Costa; Milena Ribeiro Paixão; Mucio Tavares de Oliveira; Patricia Cury; Paula R Villaça; Pedro Silvio Farsky; Rinaldo F Siciliano; Roberto Henrique Heinisch; Rogerio Souza; Sandra F M Gualandro; Tarso Augusto Duenhas Accorsi; Wilson Mathias Journal: Arq Bras Cardiol Date: 2017 Jan-Feb Impact factor: 2.000
Authors: André Arpad Faludi; Maria Cristina de Oliveira Izar; José Francisco Kerr Saraiva; Ana Paula Marte Chacra; Henrique Tria Bianco; Abrahão Afiune; Adriana Bertolami; Alexandre C Pereira; Ana Maria Lottenberg; Andrei C Sposito; Antonio Carlos Palandri Chagas; Antonio Casella; Antônio Felipe Simão; Aristóteles Comte de Alencar; Bruno Caramelli; Carlos Costa Magalhães; Carlos Eduardo Negrão; Carlos Eduardo Dos Santos Ferreira; Carlos Scherr; Claudine Maria Alves Feio; Cristiane Kovacs; Daniel Branco de Araújo; Daniel Magnoni; Daniela Calderaro; Danielle Menosi Gualandro; Edgard Pessoa de Mello; Elizabeth Regina Giunco Alexandre; Emília Inoue Sato; Emilio Hideyuki Moriguchi; Fabiana Hanna Rached; Fábio César Dos Santos; Fernando Henpin Yue Cesena; Francisco Antonio Helfenstein Fonseca; Henrique Andrade Rodrigues da Fonseca; Hermes Toros Xavier; Isabela Cardoso Pimentel Mota; Isabela de Carlos Back Giuliano; Jaqueline Scholz Issa; Jayme Diament; João Bosco Pesquero; José Ernesto Dos Santos; José Rocha Faria; José Xavier de Melo; Juliana Tieko Kato; Kerginaldo Paulo Torres; Marcelo Chiara Bertolami; Marcelo Heitor Vieira Assad; Márcio Hiroshi Miname; Marileia Scartezini; Neusa Assumpta Forti; Otávio Rizzi Coelho; Raul Cavalcante Maranhão; Raul Dias Dos Santos; Renato Jorge Alves; Roberta Lara Cassani; Roberto Tadeu Barcellos Betti; Tales de Carvalho; Tânia Leme da Rocha Martinez; Viviane Zorzanelli Rocha Giraldez; Wilson Salgado Journal: Arq Bras Cardiol Date: 2017-07 Impact factor: 2.000