Skip to main content
SpringerLink
Log in

Stratifying Thromboembolic Risk: Why Is Your Patient on Antithrombotic Medications?

  • Chapter
  • First Online:
Hemostasis in Dentistry

  • 875 Accesses

Abstract

Utilization of antithrombotic medications is extremely prevalent and may be indicated for a variety of disease states. Additionally, innovation and advancements in pharmacotherapy have increased the number of antithrombotic medications available to prescribers, the combinations of medications utilized, and durations of usage with these therapies. Understanding why patients are on certain antithrombotic therapies and the risks of discontinuing these therapies is a vital component of preparation for dental procedures patients may undergo. This chapter will highlight the most common indications for antithrombotic therapy, suggested medications for each disease state, along with recommended intensity and duration of treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Baron TH, Kamath PS, McBane RD. Management of antithrombotic therapy in patients undergoing invasive procedures. N Engl J Med. 2013;368:2113–24.

    Article  PubMed  Google Scholar 

  2. Williams CD, Chan AT, Elman MR, et al. Aspirin use among adults in the U.S.: results of a national survey. Am J Prev Med. 2015;48(5):501–8.

    Article  PubMed  Google Scholar 

  3. Hsu JC, Maddox TM, Kennedy KF, et al. Oral anticoagulant therapy prescription in patients with atrial fibrillation across the spectrum of stroke risk: insights from the NCDR PINNACLE Registry. JAMA Cardiol. 2016;1(1):55–62.

    Article  PubMed  Google Scholar 

  4. Chugh SS, Havmoeller R, Narayanan K, et al. Worldwide epidemiology of atrial fibrillation: a global burden of disease 2010 study. Circulation. 2014;129(8):837–47.

    Article  PubMed  Google Scholar 

  5. Markides V, Schilling RJ. Atrial fibrillation: classification, pathophysiology, mechanisms and drug treatment. Heart. 2003;89(8):939–43.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Iwasaki YK, Nishida K, Kato T, Nattel S. Atrial fibrillation pathophysiology: implications for management. Circulation. 2011;124:2264–74.

    Article  PubMed  Google Scholar 

  7. Wann LS, Curtis AB, January CT, et al. 2011 ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation (updating the 2006 guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011;123(1):104–23.

    Article  PubMed  Google Scholar 

  8. Fuster V, Rydn LE, Cannom DS, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to revise the 2001 guidelines for the management of patients with atrial fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114(7):e257–354.

    Article  PubMed  Google Scholar 

  9. Kannel WB, Wolf PA, Benjamin EJ, Levy D. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol. 1998;82(8A):2N–9N.

    Article  PubMed  Google Scholar 

  10. Ferrari R, Bertini M, Blomstrom-Lundqvist C, et al. An update on atrial fibrillation in 2014: from pathophysiology to treatment. Int J Cardiol. 2016;203:22–9.

    Article  PubMed  Google Scholar 

  11. Akyürek O, Sayin T, Dinçer I, Karaoguz R, Güldal M, Oral D. Lengthening of intraatrial conduction time in atrial fibrillation and its relation with early recurrence of atrial fibrillation. Jpn Heart J. 2001;42(5):575–84.

    Article  PubMed  Google Scholar 

  12. Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Vasan RS, et al. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation. 2004;110(9):1042–6.

    Article  PubMed  Google Scholar 

  13. van Walraven C, Hart RG, Connolly S, Austin PC, Mant J, Hobbs FD, Koudstaal PJ, Petersen P, Perez-Gomez F, Knottnerus JA, Boode B, Ezekowitz MD, Singer DE. Effect of age on stroke prevention therapy in patients with atrial fibrillation: the atrial fibrillation investigators. Stroke. 2009;40(4):1410–6.

    Article  PubMed  Google Scholar 

  14. Fox CS, Parise H, D’Agostino RB Sr, Lloyd-Jones DM, Vasan RS, Wang TJ, et al. Parental atrial fibrillation as a risk factor for atrial fibrillation in offspring. JAMA. 2004;291(23):2851–5.

    Article  PubMed  Google Scholar 

  15. Lubitz SA, Yin X, Fontes JD, Magnani JW, Rienstra M, Pai M, et al. Association between familial atrial fibrillation and risk of new-onset atrial fibrillation. JAMA. 2010;304(20):2263–9.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22(8):983–8.

    Article  PubMed  Google Scholar 

  17. Welles CC, Whooley MA, Na B, et al. The CHADS(2) score predicts ischemic stroke in the absence of atrial fibrillation among subjects with coronary heart disease: data from the Heart and Soul Study. Am Heart J. 2011;162(3):555–61.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Olesen JB, Lip GY, Hansen ML, Hansen PR, Tolstrup JS, Lindhardsen J, et al. Validation of risk stratification schemes for predicting stroke and thromboembolism in patients with atrial fibrillation: nationwide cohort study. BMJ. 2011;342:d124.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Gage BF, Waterman AD, Shannon W, et al. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001;285(22):2864–70.

    Article  PubMed  Google Scholar 

  20. Kirchhof P, Benussi S, Kotecha D, et al. ESC guidelines for the management of atrial fibrillation. Eur Heart J. 2016;37(38):2893–962.

    Article  PubMed  Google Scholar 

  21. Gage BF, Yan Y, Milligan PE, Waterman AD, Culverhouse R, Rich MW, et al. Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J. 2006;151(3):713–9.

    Article  PubMed  Google Scholar 

  22. Pisters R, Lane DA, Nieuwlaat R, et al. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010;138:1093–100.

    Article  PubMed  Google Scholar 

  23. Lane DA, Lip GYH. Use of the CHA2DS2-VASc and HAS-BLED scores to aid decision making for thromboprophylaxis in nonvalvular atrial fibrillation. Circulation. 2012;126:860–5.

    Article  PubMed  Google Scholar 

  24. Stroke Prevention in Atrial Fibrillation Investigators. Stroke prevention in atrial fibrillation study. Final results. Circulation. 1991;84:527–39.

    Article  Google Scholar 

  25. The ACTIVE Writing Group on behalf of the ACTIVE Investigators. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet. 2006;367:1903–12.

    Article  Google Scholar 

  26. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139–51.

    Article  PubMed  Google Scholar 

  27. Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365:883–91.

    Article  PubMed  Google Scholar 

  28. Granger CB, Alexander JH, McMurray JJV, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–92.

    Article  PubMed  Google Scholar 

  29. Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369:2093–104.

    Article  PubMed  Google Scholar 

  30. Kirley K, Qato DM, Kornfield R, Stafford RS, Alexander GC. National trends in oral anticoagulant use in the United States, 2007 to 2011. Circ Cardiovasc Qual Outcomes. 2012;5(5):615–21.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Barnes GD, Lucas E, Alexander GC, Goldberger ZD. National trends in ambulatory oral anticoagulant use. Am J Med. 2015;128(12):1300–5.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Piazza G, Hohlfelder B, Goldhaber SZ. Handbook for venous thromboembolism. New York: Springer; 2015.

    Book  Google Scholar 

  33. Office of the Surgeon General (US); National Heart, Lung, and Blood Institute (US). The surgeon general’s call to action to prevent deep vein thrombosis and pulmonary embolism. Rockville, MD: Office of the surgeon general (US); 2008. Available from: https://www.ncbi.nlm.nih.gov/books/NBK44178/

    Google Scholar 

  34. Lang IM, Madani M. Update on chronic thromboembolic pulmonary hypertension. Circulation. 2014;130:508–18.

    Article  PubMed  Google Scholar 

  35. Vazquez SR, Kahn SR. Postthrombotic syndrome. Circulation. 2010;121:e217–9.

    Article  PubMed  Google Scholar 

  36. Kyrle PA, Eichinger S. Is Virchow’s triad complete? Blood. 2009;114:1138–9.

    Article  PubMed  Google Scholar 

  37. Karcutskie CA, Meizoso JP, Ray JJ, et al. Association of mechanism of injury with risk for venous thromboembolism after trauma. JAMA Surg. 2017;152(1):35–40.

    Article  PubMed  Google Scholar 

  38. Creager MA, Luscher TF. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: part I. Circulation. 2003;108:1527–32.

    Article  PubMed  Google Scholar 

  39. Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob GE, Comerota AJ. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edn). Chest. 2008;133(Suppl):454S–545S.

    Article  PubMed  Google Scholar 

  40. Schulman S, Kearon C, Kakkar AK, et al. Dabigatran versus warfarin in the treatment of acute venous thromboembolism. N Engl J Med. 2009;361:2342–52.

    Article  PubMed  Google Scholar 

  41. The EINSTEIN-PE Investiagtors. Oral rivaroxaban for the treatment of symptomatic pulmonary embolism. N Engl J Med. 2012;366:1287–97.

    Article  Google Scholar 

  42. Investigators TEINSTEIN. Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med. 2010;363:2499–510.

    Article  Google Scholar 

  43. Agnelli G, Butler HR, Cohen A, et al. Oral apixaban for the treatment of acute venous thromboembolism. N Engl J Med. 2013;369:799–808.

    Article  PubMed  Google Scholar 

  44. Investigators TH-VTE. Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism. N Engl J Med. 2013;369:1406–15.

    Article  Google Scholar 

  45. Hutten BA, Prins MH, Gent M, Ginsberg J, Tijssen JG, Buller HR. Incidence of recurrent thromboembolic and bleeding complications among patients with venous thromboembolism in relation to both malignancy and achieved international normalized ratio: a retrospective analysis. J Clin Oncol. 2000;18:3078–83.

    Article  PubMed  Google Scholar 

  46. Prandoni P, Lensing AW, Piccioli A, et al. Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis. Blood. 2002;100:3484–8.

    Article  PubMed  Google Scholar 

  47. Lee AYY, Levine MN, Baker RI, et al. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med. 2003;349:146–53.

    Article  PubMed  Google Scholar 

  48. Lyman GH, Bohlke K, Khorana AA, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: american society of clinical oncology clinical practice guideline update 2014. J Clin Oncol. 2015;33(6):654–6.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Vedovati MC, Germini F, Agnelli G, Becattini C. Direct oral anticoagulants in patients with VTE and cancer: a systematic review and meta-analysis. Chest. 2015;147(2):475.

    Article  PubMed  Google Scholar 

  50. Kearon C, Akl EA, Omelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 2016;149:315–52.

    Article  PubMed  Google Scholar 

  51. Wells PS, Forgie MA, Rodger MA. Treatment of venous thromboembolism. JAMA. 2014;311(7):717–28.

    Article  PubMed  Google Scholar 

  52. Kearon C, Akl EA. Duration of anticoagulant therapy for deep vein thrombosis and pulmonary embolism. Blood. 2014;123(12):1794–801.

    Article  PubMed  Google Scholar 

  53. Nkomo VT, Gardin JM, Skelton TN, Gottdiener JS, Scott CG, Enriquez-Sarano M. Burden of valvular heart diseases: a population-based study. Lancet. 2006;368:1005–11.

    Article  PubMed  Google Scholar 

  54. Barreto-Filho JA, Wang Y, Dodson JA, et al. Contemporary trends in aortic valve surgery for elderly patients in the United States, 1999–2010. JAMA. 2013;310:2078–85.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Bonow RO. Improving outlook for elderly patients with aortic stenosis. JAMA. 2013;310:2045–7.

    Article  PubMed  Google Scholar 

  56. Nishimura RA, Otto CM, Bonow RO. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014;63(22):e57.

    Article  PubMed  Google Scholar 

  57. Lindman BR, Clavel MA, Mathieu P, et al. Calcific aortic stenosis. Nat Rev Dis Primers. 2016;2:16006.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Jones EC, Devereux RB, Roman MJ, et al. Prevalence and correlates of mitral regurgitation in a population-based sample (the Strong Heart Study). Am J Cardiol. 2001;87(3):298.

    Article  PubMed  Google Scholar 

  59. Marijon E, Ou P, Celermajer DS, et al. Prevalence of rheumatic heart disease detected by echocardiographic screening. N Engl J Med. 2007;357(5):470.

    Article  PubMed  Google Scholar 

  60. Whitlock RP, Sun JC, Fremes SE, et al. Antithrombotic and thrombolytic therapy for valvular disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e576S.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC), European Association for Cardio-Thoracic Surgery (EACTS). Guidelines on the management of valvular heart disease (version 2012). Eur Heart J. 2451;33(19):2012.

    Google Scholar 

  62. Singhal P, Luk A, Butany L. Bioprosthetic heart valves: impact of implantation on biomaterials. ISRN Biomater. 2013;2013:728791.

    Article  Google Scholar 

  63. Pibarot P, Dumesnil JG. Prosthetic heart valves: selection of the optimal prosthesis and long-term management. Circulation. 2009;119:1034–48.

    Article  PubMed  Google Scholar 

  64. Allou N, Piednoir P, Berroëta C, et al. Incidence and risk factors of early thromboembolic events after mechanical heart valve replacement in patients treated with intravenous unfractionated heparin. Heart. 2009;95(20):1694.

    Article  PubMed  Google Scholar 

  65. Puskas J, Gerdisch M, Nichols D, et al. Reduced anticoagulation after mechanical aortic valve replacement: interim results from the prospective randomized on-x valve anticoagulation clinical trial randomized Food and Drug Administration investigational device exemption trial. J Thorac Cardiovasc Surg. 2014;147:1202–10.

    Article  PubMed  Google Scholar 

  66. Eikelboom JW, Connolly SJ, Brueckmann M, et al. Dabigatran versus warfarin in patients with mechanical heart valves. N Engl J Med. 2013;369:1206–14.

    Article  PubMed  Google Scholar 

  67. Kitchens CS. Concept of hypercoagulability: a review of its development, clinical application, and recent progress. Semin Thromb Hemost. 1985;11:293–315.

    Article  PubMed  Google Scholar 

  68. Reiner AP, Siscovick DS, Rosendaal FR. Hemostatic risk factors and arterial thrombotic disease. Thromb Haemost. 2001;85:584–95.

    Article  PubMed  Google Scholar 

  69. Chan MY, Andreotti F, Becker RC. Hypercoagulable states in cardiovascular disease. Circulation. 2008;118:2286–97.

    Article  PubMed  Google Scholar 

  70. Zivelin A, Rosenberg N, Faier S, et al. A single genetic origin for the common prothrombotic G20210A polymorphism in the prothrombin gene. Blood. 1998;92:1119–24.

    PubMed  Google Scholar 

  71. Seligsohn U, Lubetsky A. Genetic susceptibility to venous thrombosis. N Engl J Med. 2001;344:1222–31.

    Article  PubMed  Google Scholar 

  72. Aiach M, Borgel D, Gaussem P, et al. Protein C and protein S deficiencies. Semin Hematol. 1997;34:205–16.

    PubMed  Google Scholar 

  73. Van Boven HH, Lane DA. Antithrombin and its inherited deficiency states. Semin Hematol. 1997;34:188–204.

    PubMed  Google Scholar 

  74. Levine JS, Branch DW, Rauch J. The antiphospholipid syndrome. N Engl J Med. 2002;346:752–63.

    Article  PubMed  Google Scholar 

  75. Greinacher A. Heparin induced thrombocytopenia. N Engl J Med. 2015;373:252–61.

    Article  PubMed  Google Scholar 

  76. Hyers TM, Agnelli G, Hull RD, et al. Antithrombotic therapy for venous thromboembolic disease. Chest. 2001;119:176S–93S.

    Article  PubMed  Google Scholar 

  77. Piazza G. Thrombophilia testing, recurrent thrombosis, and women’s health. Circulation. 2014;130:283–7.

    Article  PubMed  Google Scholar 

  78. Ornstein DL, Cushman M. Factor V Leiden. Circulation. 2003;107:e94–7.

    Article  PubMed  Google Scholar 

  79. Laslett LJ, Alagona P Jr, Clark BA III, et al. The worldwide environment of cardiovascular disease: prevalence, diagnosis, therapy, and policy issues: a report from the American College of Cardiology. J Am Coll Cardiol. 2012;60(25 Suppl):S1.

    Article  PubMed  Google Scholar 

  80. Roth GA, Huffman MD, Moran AE, et al. Global and regional patterns in cardiovascular mortality from 1990 to 2013. Circulation. 2015;132(17):1667.

    Article  PubMed  Google Scholar 

  81. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937.

    Article  PubMed  Google Scholar 

  82. Dagostino RB Sr, Grundy S, Sullivan LM, Wilson P, CHD Risk Prediction Group. Validation of the Framingham coronary heart disease prediction scores: results of a multiple ethnic groups investigation. JAMA. 2001;286(2):180.

    Article  Google Scholar 

  83. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection. Evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation. 2002;106(25):3143.

    Google Scholar 

  84. Muntner P, Colantonio LD, Cushman M, et al. Validation of the atherosclerotic cardiovascular disease pooled cohort risk equations. JAMA. 2014;311(14):1406.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Vandvik PO, Lincoff AM, Gore JM, et al. Primary and secondary prevention of cardiovascular disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e637S.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Nansseau JRN, Noubiap JJN. Aspirin for primary prevention of cardiovascular disease. Thromb J. 2015;13:38.

    Article  Google Scholar 

  87. Pignone M, Alberts MJ, Colwell JA, et al. Aspirin for primary prevention of cardiovascular events in people with diabetes: a position statement of the American Diabetes Association, a Scientific Statement of the American Heart Association, and an Expert Consensus Document of the American College of Cardiology Foundation. Circulation. 2010;121:2694–701.

    Article  PubMed  Google Scholar 

  88. Fox KA, Goodman SG, Klein W, et al. Management of acute coronary syndromes. Variations in practice and outcome; findings from the Global Registry of Acute Coronary Events (GRACE). Eur Heart J. 2002;23(15):1177.

    Article  PubMed  Google Scholar 

  89. Go AS, Mozaffarian D, Roger VL, et al. On Behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics–2013 update: a report from the American Heart Association. Circulation. 2013;127(1):e6–e245.

    Article  PubMed  Google Scholar 

  90. Hasdai D, Behar S, Wallentin L, et al. A prospective survey of the characteristics, treatments and outcomes of patients with acute coronary syndromes in Europe and the Mediterranean basin; the Euro Heart Survey of Acute Coronary Syndromes (Euro Heart Survey ACS). Eur Heart J. 2002;23(15):1190.

    Article  PubMed  Google Scholar 

  91. Thygesen K, Alpert JS, Jaffe AS, et al. Third universal definition of myocardial infarction. Circulation. 2012;126(16):2020.

    Article  PubMed  Google Scholar 

  92. Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012;126:e354–245.

    Article  PubMed  Google Scholar 

  93. Bhatt DL, Fox KAA, Hacke W, et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med. 2006;354:1706–17.

    Article  PubMed  Google Scholar 

  94. Kulik A, Ruel M, Jneid H, et al. Secondary prevention after coronary artery bypass graft surgery: a scientific statement from the American Heart Association. Circulation. 2015;2015:CIR.0000000000000182.

    Google Scholar 

  95. The Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med. 2001;345:494–502.

    Article  Google Scholar 

  96. Mehta SR, Yusuf S, Peters RJ, et al. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet. 2001;358(9281):527–33.

    Article  PubMed  Google Scholar 

  97. Une D, Al-Atassi T, Kulik A, Voisine P, Le May M, Ruel M. Impact of clopidogrel plus aspirin versus aspirin alone on the progression of native coronary artery disease after bypass surgery: analysis from the Clopidogrel After Surgery for Coronary Artery DiseasE (CASCADE) randomized trial. Circulation. 2014;130(11 Suppl 1):S12–8.

    Article  PubMed  Google Scholar 

  98. Wiviott SD, Braunwald E, McCabe CH, et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2007;357:2001–15.

    Article  PubMed  Google Scholar 

  99. Wallentin L, Becker RC, Budaj A, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009;361:1045–57.

    Article  PubMed  Google Scholar 

  100. Morice MC, Urban P, Greene S, Schuler G, Chevalier B. Why are we still using coronary bare-metal stents? J Am Coll Cardiol. 2013;61(10):1121–3.

    Article  Google Scholar 

  101. Ernst A, Bulum J. New generations of drug-eluting stents – a brief review. EMJ Int Cardiol. 2014;1:100–6.

    Google Scholar 

  102. Levine GN, Bates ER, Bittl JA, et al. ACC/AHA guideline update on duration of dual antiplatelet therapy in CAD patients. J Am Coll Cardiol. 2016;2016:CIR.0000000000000404.

    Google Scholar 

  103. Bhatt DL, Hulot JS, Moliterno DJ, Harrington RA. Antiplatelet and anticoagulation therapy for acute coronary syndromes. Circ Res. 2014;114:1929–43.

    Article  PubMed  Google Scholar 

  104. Sabatine MS, Cannon CP, Gibson CM, et al. Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation. N Engl J Med. 2005;352:1179–89.

    Article  PubMed  Google Scholar 

  105. Steinhubl SR, Berger PB, Mann JT III, et al. Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA. 2002;288(19):2411–20.

    Article  PubMed  Google Scholar 

  106. Mehta SR, Tanguay JF, Eikelboom JW, et al. Double-dose versus standard-dose clopidogrel and high-dose versus low-dose aspirin in individuals undergoing percutaneous coronary intervention for acute coronary syndromes (CURRENT-OASIS 7): a randomised factorial trial. Lancet. 2010;376(9748):1233–43.

    Article  PubMed  Google Scholar 

  107. Bonaa KH, Mannsverk J, Wiseth R, et al. Drug-eluting or bare-metal stents for coronary artery disease. N Engl J Med. 2016;375:1242–52.

    Article  PubMed  Google Scholar 

  108. Butt M, Connolly D, Lip GY. Drug-eluting stents: a comprehensive appraisal. Futur Cardiol. 2009;5(2):141–57.

    Article  Google Scholar 

  109. Iakovou I. Thrombosis after stent implantation: how much of a problem is there? Futur Cardiol. 2008;4(3):261–7.

    Article  Google Scholar 

  110. Mauri L, Kereiakes DJ, Yeh RW, et al. Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents. N Engl J Med. 2014;371:2155–66.

    Article  PubMed  PubMed Central  Google Scholar 

  111. Van der Worp HB, van Gijn J. Acute ischemic stroke. N Engl J Med. 2007;357:572–9.

    Article  PubMed  Google Scholar 

  112. Ovbiagele B, Nguyen-Hyunh MN. Stroke epidemiology: advancing our understanding of disease mechanism and therapy. Neurotherapeutics. 2011;8(3):319–29.

    Article  PubMed  PubMed Central  Google Scholar 

  113. Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45:2160–236.

    Article  PubMed  Google Scholar 

  114. Adams HP, Bendixen BH, Kappelle LJ, et al. Classification of subtype of acute ischemic stroke: definitions for use in a multicenter clinical trial. Stroke. 1993;24:35–41.

    Article  PubMed  Google Scholar 

  115. Ay H, Furie KL, Singhal A, Smith WS, Sorensen AG, Koroshetz WJ. An evidence-based causative classification system for acute ischemic stroke. Ann Neurol. 2005;58(5):688–97.

    Article  PubMed  Google Scholar 

  116. International Stroke Trial Collaborative Group. The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. Lancet. 1997;349(9065):1569–81.

    Article  Google Scholar 

  117. Pratt CM, Moye LA. The cardiac arrhythmia suppression trial. Circulation. 1995;91:245–7.

    Article  PubMed  Google Scholar 

  118. Antithrombotic Trialists’ (ATT) Collaboration. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet. 2009;373(9678):1849–60.

    Article  Google Scholar 

  119. Rothwell PM, Algra A, Chen Z, Diener HC, Norrving B, Mehta Z. Effects of aspirin on risk and severity of early recurrent stroke after transient ischaemic attack and ischaemic stroke: time-course analysis of randomised trials. Lancet. 2016;388(10042):365–75.

    Article  PubMed  PubMed Central  Google Scholar 

  120. CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Lancet. 1996;348(9038):1329–39.

    Article  Google Scholar 

  121. Claiborne Johnston S, Amarenco P, Albers GW, et al. Ticagrelor versus aspirin in acute stroke or transient ischemic attack. N Engl J Med. 2016;375:35–43.

    Article  PubMed  Google Scholar 

  122. Wang Y, Wang Y, Zhao X, et al. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N Engl J Med. 2013;369:11–9.

    Article  PubMed  Google Scholar 

  123. Diener HC, Bogousslavsky J, Brass LM, et al. Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial. Lancet. 2004;364(9431):331–7.

    Article  PubMed  Google Scholar 

  124. Diener HC, Cunha L, Forbes C, Sivenius J, Smets P, Lowenthal A. European stroke prevention study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurol Sci. 1996;143(1–2):1–13.

    Article  PubMed  Google Scholar 

  125. Verro P, Gorelick PB, Nguyen D. Aspirin plus dipyridamole versus aspirin for prevention of vascular events after stroke or TIA: a meta-analysis. Stroke. 2008;39:1358–63.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cleveland Clinic, Cleveland, OH, USA

    Benjamin Hohlfelder

Authors
  1. Benjamin Hohlfelder
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Benjamin Hohlfelder .

Editor information

Editors and Affiliations

  1. Department of Dentistry, St. Joseph’s Regional Medical Center, Department of Dentistry, Paterson, New Jersey, USA

    Richard P. Szumita

  2. Department of Pharmacy Services, Brigham and Women’s Hospital, Department of Pharmacy Services, Boston, Massachusetts, USA

    Paul M. Szumita

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hohlfelder, B. (2018). Stratifying Thromboembolic Risk: Why Is Your Patient on Antithrombotic Medications?. In: Szumita, R., Szumita, P. (eds) Hemostasis in Dentistry. Springer, Cham. https://doi.org/10.1007/978-3-319-71240-6_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-71240-6_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-71239-0

  • Online ISBN: 978-3-319-71240-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation