Manager Centre de Pharmaco-épidémiologie de l'AP-HP~Title Survey about oral anticoagulant peri-procedural management in patients undergoing an oral surgery, implantology or periodontology~Acronym PRADICO~Investigator Coordinator Isabelle MAHE~Number of investigational sites 100~Number of patients 2000~Population Patients receiving oral anticoagulant undergoing an oral surgery, implantology or periodontology~Research calendar Duration of inclusions: 1 year Duration of follow up: 30 days Study duration: 13 months~Selection criteria~Inclusion criteria :~Patients receiving long-term oral anticoagulant (defined as duration of treatment of at least 1 month) and referred for an invasive procedure (oral surgery, implantology or periodontology) to an oral surgeon member of the SFCO (Société Française de Chirurgie Orale) or a periodontologist member of the SFPIO (Société Française de Parodontologie et d'Implantologie Orale) taking part to the study.~Each investigator will include 10 patients treated with long-term DOAC, and 10 consecutive patients treated with long-term VKA. For the DOAC group, inclusion will be continued until the inclusion of 333 patients for each molecule (apixaban, rivaroxaban, edoxaban).~Non-inclusion criteria :~Patients receiving both VKA and antiplatelet agents Patients receiving both direct oral anticoagulant and antiplatelet agents~Objectives~Primary aim:~To assess the composite rate of thromboembolic and bleeding events occurring within the peri-procedural period, in patients on long-term DOAC and VKA and undergoing an oral surgery, implantology or periodontology.~Secondary aims :~To identify risk factors for bleeding during the peri-procedural period~To identify risk factors for thromboembolic events during the peri-procedural period~To describe the peri-procedural management of each treatment (VKA or DOAC)~To identify prescribers involved in the possible change of anticoagulant prescription prior the oral surgery~To compare the risk of bleeding on DOAC and on VKA~To compare the risk of thromboembolic complications on DOAC and on VKA~To evaluate the net clinical benefit of DOAC compared to VKA treatment~Endpoints~Primary endpoint :~A composite outcome: the occurrence rate of hemorrhagic and/or thromboembolic events during the peri-procedural period.~Secondary endpoints :~Incidence of bleeding events~incidence of thromboembolic events~net clinical benefit of DOAC compared to VKA~Methodology Prospective observational non interventional multicentric cohort study in adult population under long-term anticoagulant treatment (DOAC or VKA) and undergoing an oral, periodontal or implant surgery, by liberal practitioners or oral specialists at hospital.~Statistical analysis The occurrence rate of hemorrhagic or thromboembolic events during peri-procedural period will be calculated globally and in each group (VKA or DOAC) as a percentage with 95% CI.~Financements Company's grant~BMS~DAIICHI SANKYO
Patients receiving long-term oral anticoagulant (defined as duration of treatment of at least 1 month of Direct Oral Anticoagulant (DAOC) or Vitamin K Antagonist (VKA)) and referred for an invasive procedure (oral surgery, implantology or periodontology) to an oral surgeon taking part to the study will be included in this prospective observational study.~The main composite outcome is the occurrence rate of hemorrhagic and/or thromboembolic events during the peri-procedural period (between 5 days before surgery plus 30 days after the invasive procedure).~0. The secondary end-points will consist of identifying risk factors for bleeding during the peri-procedural period, risk factors for thromboembolic events during the peri-procedural period, the peri-procedural management of each treatment (VKA or DOAC), the prescribers involved in the possible change of anticoagulant prescription prior the oral surgery All outcome events will be blindly adjudicated by a central independent adjudication committee.