Why the study?
Studies frequently present grouped anticoagulation data during dental procedures, leaving a need for information on individual anticoagulant management to guide dentists.
What are the rates of periprocedural edoxaban interruption and associated bleeding and thrombotic events in patients with atrial fibrillation undergoing dental procedures?
What are the rates of periprocedural edoxaban interruption and associated bleeding and thrombotic events in patients with atrial fibrillation undergoing dental procedures?
In patients with atrial fibrillation taking edoxaban, dental procedures are associated with low bleeding rates and no thrombotic events, with edoxaban typically continued for cleanings and interrupted for extractions.
Low bleeding observed with selective edoxaban management in dental procedures; leaves open need for randomized trials in AF.
INTRODUCTION: Literature reviews support continuing anticoagulation during dental procedures. However, studies often present grouped anticoagulation data, and information on individual anticoagulant management would be helpful to dentists. The Edoxaban Management in Diagnostic and Therapeutic Procedures (EMIT-AF/VTE) programme (NCT02950168; NCT02951039) demonstrated low periprocedural bleeding and thrombotic event rates in patients with atrial fibrillation receiving edoxaban. AIMS: To report periprocedural edoxaban interruption and clinical events in patients from EMIT-AF/VTE who underwent dental procedures. METHODS: Dental procedures were categorised by type (cleaning/noncleaning). Edoxaban interruption, bleeding events, and thrombotic events were observed 5 days preprocedure through 29 days postprocedure. RESULTS: Overall, 196 patients underwent 350 cleaning and/or noncleaning procedures; most patients (171/196 [87.2%]) underwent noncleaning procedures (282/350 [80.6%]), whereas 48/196 (24.5%) underwent 68/350 (19.4%) cleaning procedures. Edoxaban was uninterrupted for most cleanings (53/68 [77.9%]). Preprocedural interruption was common for single and multiple tooth extractions (single, 67/100 [67.0%]; multiple, 16/30 [53.3%]). The only major bleeding occurred after an unrelated cleaning. Minor bleeding occurred in 1/68 (1.5%) cleaning and 4/282 (1.4%) noncleaning procedures. There were no thrombotic events. CONCLUSIONS: For most cleanings, edoxaban was not interrupted, whereas preprocedural interruption was more common for tooth extractions. Overall, bleeding rates were low, and no thrombotic events occurred.
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Chen et al. (2023) studied this question.
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