Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Effect of clopidogrel on post-extraction clotting in patients on dual antiplatelet therapy

Yaqiong Zhang, Yijie Zhao, Meng Wang, Jiaqi Wang, Zhicheng Yang, Mengmeng Lu

Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital, Fudan University & Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai 200031, China;

For correspondence:- Mengmeng Lu Email: lumengmeng_kq@fudan.edu.cn

Accepted: 12 December 2022 Published: 31 January 2023

Citation: Zhang Y, Zhao Y, Wang M, Wang J, Yang Z, Lu M. Effect of clopidogrel on post-extraction clotting in patients on dual antiplatelet therapy. Trop J Pharm Res 2023; 22(1):189-197 doi: 10.4314/tjpr.v22i1.26

© 2023 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To evaluate the association between the platelet inhibition rate of clopidogrel (CLO-PIR) and post-extraction clotting status in DAPT patients.

Methods: Ninety (90) eligible patients scheduled for a single tooth extraction were enrolled in this study. The CLO-PIR and platelet inhibition rate of aspirin (ASA-PIR) were determined by thromboelastography platelet mapping assay. Post-extraction clotting assessments were performed, and a complete intra-alveolar clot formation within 30 min post-operation was defined as normal clotting. For clot formation exceeding 30 min, it was defined as prolonged bleeding.

Results: At a similar level of ASA-PIR, a higher proportion of patients with normal CLO-PIR (≤ 75 %) exhibited normal clotting, compared with those featuring high CLO-PIR (>75 %, p < 0.001). However, in patients with similar CLO-PIRs, the clotting results varied insignificantly, with increase in ASA-PIR. The effect of CLO-PIR was further validated using logistic regression analysis (odds ratio = 1.071, 95 % confidence interval: 1.024 - 1.120, p = 0.003), and receiver operating characteristic curve analysis revealed that a 78.6 % CLO-PIR was the rational cut-off point.

Conclusion: This study preliminarily demonstrates the prominence of high clopidogrel responsiveness in slowing the post-extraction clotting process in DAPT patients.

Keywords: Dual antiplatelet therapy, Clopidogrel responsiveness, Dental extraction, Post-extraction clotting, Thromboelastography platelet mapping assay, Platel