Risk of post-extraction bleeding with direct oral anticoagulant compared with warfarin: Retrospective cohort study using large scale claims data in Japan

Ono, Sachiko; Ishimaru, Miho; Yokota, Isao; Konishi, Takaaki; Okada, Akira; Ono, Yoshiyasu; Matsui, Hiroki; Itai, Shunsuke; Yonenaga, Kazumichi; Tonosaki, Kanata; Watanabe, Rinji; Hoshi, Kazuto; Yasunaga, Hideo

doi:10.1016/j.thromres.2022.12.007

Cited by 9 publications

(4 citation statements)

References 31 publications

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“…It is crucial to underscore that the ability to arrest local bleeding remains feasible, and adherence to standardized clinical protocols remains foundational and assures the efficacy of interventions for post-tooth extraction hemorrhage. [12][13][14] There was an elevated prevalence of patients exhibiting mandibular wisdom teeth and maxillary molars in this study. Mandibular wisdom teeth typically manifest as impacted teeth, necessitating interventions that may precipitate bleeding, including flapping, deboning, and crown incisions.…”

Section: Discussionmentioning

confidence: 88%

Analysis of Risk Factors for Post-Extraction Bleeding and Study on Emergency Intervention Strategies

Shao,

Xu,

Yang

et al. 2024

RMHP

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Objective The objective of this investigation is to delineate the distributional attributes of factors correlated with post-tooth extraction bleeding and to scrutinize corresponding strategies for emergency prevention and intervention. Methods The chi-squared test and rank sum test were deployed to evaluate fluctuations in blood loss. Univariate and multivariate binary logistic regression methodologies were employed to compute the odds ratio (OR) and its associated 95% confidence interval (95% CI). Furthermore, we delved into the relationship between each contributing factor and blood loss. Concurrently, univariate and multivariate logistic regression techniques were utilized to probe the nexus between blood loss and treatment modalities. Results Following adjustments for pertinent factors, the outcomes of multivariate analyses unveiled an escalated susceptibility to bleeding among male patients and individuals aged 60 years or older. The adjusted OR values and their corresponding 95% CI were determined as follows: OR = 1.54 (95% CI: 1.34–1.77, P < 0.001), OR = 0.74 (95% CI: 0.59–0.91, P = 0.005), OR = 0.58 (95% CI: 0.42–0.80, P = 0.001). Additionally, the results of multivariate logistic regression analysis indicated that, in contrast to individuals experiencing minimal blood loss, the OR values associated with treatment modalities for patients encountering substantial blood loss, namely iodoform gauze strips, sutures, collagen, and compression, were noted as follows: OR = 220.80 (95% CI: 151.43–321.95, P < 0.001), OR = 69.40 (95% CI: 46.11–104.44, P < 0.001), OR = 52.78 (95% CI: 34.66–80.38, P < 0.001), OR = 12.85 (95% CI: 9.46–17.45, P < 0.001). Conclusion It is imperative to prioritize the scrutiny of risk factors associated with post-tooth extraction hemorrhage, with the aim of preemptively averting incidences of bleeding subsequent to tooth extraction. Moreover, it is paramount to offer expert and tailored emergency interventions designed to address diverse case scenarios.

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Section: Discussionmentioning

confidence: 88%

Analysis of Risk Factors for Post-Extraction Bleeding and Study on Emergency Intervention Strategies

Shao,

Xu,

Yang

et al. 2024

RMHP

View full text Add to dashboard Cite

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“…A recent study showed that there was no significant difference in postextraction bleeding in patient taking direct oral anticoagulants (ie, dabigatran, rivaroxaban, apixaban, and edoxaban) compared with those taking warfarin (1.9% vs 2.2%). 24 Bleeding complications in anticoagulated or antiplatelet factor-treated patients after simple tooth extractions were found to be low. 25 The frequency of hemorrhage after tooth extraction was similar in patients receiving continuous dabigatran or rivaroxaban compared with the warfarin group.…”

Section: Discussionmentioning

confidence: 96%

Oral Health Clearance Outcomes for Cardiovascular Surgery

Zhou,

Viozzi,

Heneberk

et al. 2024

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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“…Of note, a reduced DOAC dose was associated with lower bleeding for NVAF patients compared with vitamin K antagonists (VKA) in the east Asia population [ 28 ]. One large cohort of east Asia patients showed lower post-extraction bleeding rates with DOAC compared with warfarin (HR: 0.84; 95% CI: 0.54–1.31) [ 29 ]. In our study, there was no significant difference in coagulation function tests between the RRD and DAPT groups.…”

Section: Discussionmentioning

confidence: 99%

Clinical Effectiveness and Safety Comparison between Reduced Rivaroxaban Dose and Dual Antiplatelet Therapy for Nonvalvular Atrial Fibrillation Patients Following Percutaneous Left Atrial Appendage Closure: A Prospective Observational Study

Li,

Jin,

Yao

et al. 2023

Rev. Cardiovasc. Med.

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Background: Device-related thrombosis (DRT) after successful closure implantation on left atrial appendage (LAA) was considered as a major challenge and optimal strategy on antithrombotic therapy remains to be solved. This study was performed to compare the clinical effectiveness and safety of reduced rivaroxaban dose (RRD) and dual antiplatelet therapy (DAPT) after left atrial appendage closure (LAAC) implantation with the Watchman device. Methods: After successful LAAC, consecutive participants were medicated with a standard DAPT or RRD. The primary endpoints included DRT, thrombosis events (TE), and bleeding events that were documented during a 12-month follow-up period. Results: 767 patients (DAPT: n = 140; RRD: n = 627) were initially included. After propensity score matching (PSM), 140 patients treated with DAPT and 280 patients with RRD were included in each group with similar baseline information, thromboembolic and bleeding risk factors, cardiovascular risk factors and concomitant medication. In the RRD group, 193 patients were on rivaroxaban 15 mg ( ) and 47 received rivaroxaban 10 mg ( ). The incidence of DRT was documented in 12 (9.3%) patients in the DAPT group and 3 (6.3%) in and 7 (3.0%) in (log-rank p = 0.050). DAPT subgroups were more likely to experience shorter time to DRT as compared to ( vs . DAPT hazard ratio (HR) = 0.334, p = 0.015, 95% CI: 0.131–0.850). The median length of DRT in the group was significantly lower than that of the DAPT group (1.721 [1.610–1.818] mm vs . 1.820 [1.725–1.925] mm, p = 0.029). Compared with the unadjusted estimated rates of ischemic events for patients with similar congestive heart failure, hypertension, age 75 years, diabetes mellitus, prior stroke or transient ischemic attack or thromboembolism, vascular disease, age 65–74 years, sex category ( - ) scores, a significant decrease of 68.6% in ischemic stroke rates was noted in the group, which contributed to a 54.9% reduction of overall thromboembolic events. The overall minor bleeding was not significantly different amongst the three groups ( p = 0.944). Procedural bleeding was more common in the DAPT group, as compared with the and groups. Conclusions: After successful closure implantation, long-term RRD significantly reduced the DRT and TE occurrence compared with DAPT.

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Risk of post-extraction bleeding with direct oral anticoagulant compared with warfarin: Retrospective cohort study using large scale claims data in Japan

Cited by 9 publications

References 31 publications

Analysis of Risk Factors for Post-Extraction Bleeding and Study on Emergency Intervention Strategies

Analysis of Risk Factors for Post-Extraction Bleeding and Study on Emergency Intervention Strategies

Oral Health Clearance Outcomes for Cardiovascular Surgery

Clinical Effectiveness and Safety Comparison between Reduced Rivaroxaban Dose and Dual Antiplatelet Therapy for Nonvalvular Atrial Fibrillation Patients Following Percutaneous Left Atrial Appendage Closure: A Prospective Observational Study

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