Antiagregacijska terapija i stomatoloπki postupci u primarnoj zdravstvenoj zaπtiti Antiaggregation therapy and dental procedures in primary healthcare

SAAEETAK: ©iroka uporaba intravaskularnih koronarnih stentova viπestruko je poveEala broj bolesnika na antiagregacijskoj terapiji acetilsalicilnom kiselinom i klopidogrelom. UzimajuEi u obzir poviπen rizik krvarenja kod ovih bolesnika raste i (ponekad pretjerana) zabrinutost prilikom planiranja manjih kirurπkih, pa tako i stomatoloπkih zahvata. Ista je rezultirala povremenim preuranjenim iskljuEivanjem spomenute terapije πto moaee, mada rijetko, imati i neaeeljene tromboembolijske komplikacije. Cilj ovog Elanka je iznijeti aktualne preporuke za postupak s bolesnicima na antiagregacijskoj terapiji kod kojih se planiraju stomatoloπki zahvati u sustavu primarne zdravstvene zaπtite. KLJU»NE RIJE»I: acetilsalicilna kiselina, klopidogrel, ekstrakcija zuba, hemostaza. SUMMARY: Extensive use of intravascular coronary stents has multiply increased a number of patients receiving antiaggregation therapy with aspirin and clopidogrel. Taking into account an increased risk of bleeding, there is an increasing (sometimes excessive) concern of minor surgical and dental procedures in these patients. This has resulted in occasional premature exclusion of the above therapy, which can, albeit rarely, lead to adverse thromboembolic complications. The aim of this article is to present the current recommendations for the management of patients receiving antiaggregation therapy where dental procedures in primary healthcare system are planned.