Oral antikoagülan kullanan atriyal fibrilasyon hastalarında spontan dişeti kanaması ve ilişkili ilaç bırakma sıklığının değerlendirilmesi: vaka kontrollü çalışma

Yıl 2021, Cilt: 46 Sayı: 1, 325 - 331, 31.03.2021

Mustafa Özcan Hasan Koca

https://doi.org/10.17826/cumj.803059

Öz

Amaç: Bu çalışmanın amacı, oral antikoagülan (OAK) kullanan atriyal fibrilasyon (AF) hastalarında spontan dişeti kanaması (SDK) ve buna bağlı ilaç bırakma sıklığının değerlendirilmesidir.
Gereç ve Yöntem: OAK ilaç kullanan 457 AF hastası taranarak spontan dişeti kanaması olan 32 hasta tespit edildi. Bu hastalar, spontan dişeti kanaması olmayan 32 AF hastası ile yaş, cinsiyet ve OAK tedavi protokolü açısından eşleştirilerek periodontal parametreleri karşılaştırıldı.
Bulgular: Çalışmaya dahil edilen total popülasyonda, 32 hastada (32/457; % 7.0) SDK saptandı ve bu hastaların 13'ünde (% 40.6) kanamaya bağlı OAK ilaç kullanımını bıraktığı tespit edildi. Plak indeksi (PI), gingival indeks (GI) ve cep derinlikleri (CD) SDK olan hastalarda anlamlı olarak daha yüksek bulundu. Gingival indeksin, hastaların OAK ilacı bırakma riskini bağımsız olarak etkilediği tespit edildi.
Sonuç: OAK tedavisi altındaki AF hastalarında, önceden var olan periodontal hastalık nedeniyle önemli oranda SDK ve buna bağlı hastanın OAK ilaç kullanımını bıraktığı gözlendi. Ayrıca gingival indeks skorları, SDK ve OAK ilacın bırakılmasında risk indikatörüdür. OAK tedavisinden önce hastaların periodontal muayenesi ve / veya tedavisi yapılması önerilir.

Anahtar Kelimeler

Atriyal Fibrilasyon, Oral antikoagülan, periodontal hastalık, gingival kanama

Evaluation of spontaneous gingival bleeding and related drug withdrawal frequency in atrial fibrillation patients using oral anticoagulants: a case-controlled study

Öz

Purpose: The aim of this study was to investigate the frequency of gingival bleeding (GB) and associated drug-withdrawal in atrial fibrillation (AF) patients using oral anti-coagulants (OAC).
Materials and Methods: 457 patients with AF receiving OAC were screened. The periodontal parameters and OAC drug-withdrawal of 32 patients with spontaneous GB were compared with 32 patients without bleeding who were matched for age, sex and OAC treatment protocol.
Results: GB was detected in 32 patients (7.0%) and 13 of these patients (40.6%) had OAC drug-withdrawal due to bleeding. The plaque index (PI), gingival index (GI) and probing pocket depths (PPD) were significantly higher in patients with GB. The GI scores independently determined the risk of OAC drug-withdrawal.
Conclusion: AF patients under OAC treatment may have significant rates of GB and subsequent OAC withdrawal due to pre-existing periodontal disease. The GI scores and GB can predict the risk of OAC drug-withdrawal. The periodontal examination and/or treatment of these patients should be performed before OAC treatment.

Anahtar Kelimeler

Atrial fibrillation, oral anti-coagulant therapy, periodontal disease, gingival bleeding

Kaynakça

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