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Updated: Nov 17, 2025
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Clinical Post-operative Bleeding During Minor Oral Surgical Procedure and In Vitro Platelet Aggregation in Patients
Surjit Singh1, Saptarshi Mandal2, Ankita Chugh3
1Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, India.
Insights
Patients on low-dose aspirin can safely undergo minor oral surgery without stopping medication. Laboratory tests show reduced platelet function, but this doesn't translate to increased bleeding risk in clinical settings, suggesting aspirin resistance.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Oral Surgery
Background:
- Discontinuing aspirin therapy for minor oral surgery increases cardiovascular and thrombotic event risk.
- Assessing the impact of low-dose aspirin on platelet function is crucial for patient management.
Purpose of the Study:
- To evaluate the effect of low-dose aspirin on platelet aggregation.
- To correlate laboratory platelet function with clinical bleeding times during minor oral surgery.
Main Methods:
- A prospective trial involving 101 patients undergoing minor oral surgery.
- Patients were divided into an aspirin therapy group and a control group.
- Platelet aggregation was analyzed using ADP and AA reagents, and bleeding times were recorded.
Main Results:
- Aspirin therapy significantly reduced platelet aggregation with both ADP and AA.
- No significant differences were observed in cutaneous or clinical oral bleeding times between groups.
- Laboratory findings of reduced platelet aggregation did not correlate with clinical bleeding outcomes.
Conclusions:
- Minor oral surgery can be performed safely without discontinuing low-dose aspirin therapy.
- The lack of clinical bleeding suggests aspirin resistance may play a role.
- This study supports continuing aspirin therapy in patients undergoing minor oral procedures.
Aim:
The risk of excessive bleeding prompts physicians to discontinue aspirin in patients on low-dose, long-term therapy which in turn puts them at the risk from adverse cardiovascular and thrombotic events. Effect of low-dose aspirin therapy on platelet function was assessed using platelet aggregation method. The aim was to correlate the laboratory platelet function with cutaneous and clinical oral bleeding time (BT).
Materials And Methods:
One hundred one patients were enrolled in this prospective trial and were allocated into two groups. Interventional or test group consisted of patients who were on aspirin therapy (75 mg/100 mg) for primary or secondary prevention of angina, myocardial infarction and stroke. Minor oral surgical procedure was performed in this group without discontinuing aspirin therapy. Control group consisted of healthy patients (under no medication) undergoing minor oral surgical procedure. Cutaneous and clinical oral BT were recorded in both the groups. Venous blood sample was drawn, and percentage platelet aggregation function was analysed using adenosine diphosphate (ADP) and arachidonic acid (AA) reagents. The percentage of platelet aggregation was then correlated with cutaneous and clinical oral BT.
Results:
A significant decrease in percentage platelet aggregation using ADP (aspirin-74.7 21.39; control-89.2 13.70) and AA (aspirin-47.6 23.11; control-82.3 20.17) was observed. However, there were no significant difference in mean cutaneous BT (aspirin-1.5 0.65 min; control-1.6 0.71 min) and clinical oral BT (aspirin-5.0 2.48 min; control-4.8 2.60 min) in aspirin and control groups.
Conclusion:
Majority of the minor oral surgical procedures can be carried out safely without discontinuing aspirin in patients on low-dose long-term therapy. This is possible because despite significant platelet aggregation evident in laboratory evaluation there is lack of its clinical corroboration owing to aspirin resistance.
Clinical Trial Registration:
CTRI/2018/02/012055.
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