PDF: Antiplatelet therapy in patients undergoing oral surgery: A systematic review and meta-analysis

Blood flow obstruction by a clot may cause ischemia and organ infarction. Thrombus formation is produced as consequence of vascular injuries, activation of the clotting process and blood flow disruption, this can happen at venous or arterial level. 

In arterial thrombosis the main etiologic factors are platelet activation and injuries to the arterial wall such as atheromatous plaques producing platelet rich thrombi. Blood Stasis and clotting are the main factors in venous thrombosis, producing thrombi rich in fibrin and erythrocytes.

Atherothrombosis, i.e., thrombus formation over an already present atherosclerotic plaque, causes cardiovascular diseases. The most important are stroke, coronary disease and peripheral vascular disease.

Nowadays, these are the top mortality causes worldwide. The World Health Organization has declared that in the year 2030 approximately 23.6 million people will die every year due to cardiovascular complications.

Therefore, antiplatelet therapy (APT) for a number of thrombotic conditions has increased in the last years in primary prevention (prophylactic) and secondary prevention.

Currently available antiplatelet agents include acetylsalicylic acid (aspirin), thienopyridines (clopidogrel, ticlopidine) IIb/IIIa platelet receptor inhibitors and phosphodiesterase inhibitors, which act upon the different phases of activation.

The protective effects of APT against cardiovascular disease have been clearly and concisely demonstrated throughout the groups at higher risk.

The number of patients under antiplatelet therapy (APT) continues to raise as current recommendations foster this practice. 

Although some recommendations to manage this treatment during oral surgery procedures exist, these have methodological shortcomings that preclude them from being conclusive.

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