Antiplatelet drugs are used for the primary and secondary prevention of cardiovascular events and cerebrovascular disease, especially in patients with ischemic heart disease, a history of coronary artery bypass previous myocardial infarction, placement of a stent, non-hemorrhagic stroke, peripheral arterial disease, and transient ischemic attacks. The most commonly prescribed antiplatelet drugs are aspirin and clopidogrel, used as single therapy or in combination. Aspirin is non-steroidal anti-inflammatory drug that exhibits analgesic, antipyretic, anti-inflammatory properties. Its Mechanism of action involves an irreversible inhibition of cyclooxygenase, which is responsible for the conversion of arachidonic acid into prostaglandins, prostacyclin, and thromboxane. Evidence suggests that a 75–100 mg daily dose of aspirin is optimal for the long-term prevention of serious vascular events in high-risk patients. Clopidogrel is an antiplatelet drug causing irreversible inhibition of an adenosine diphosphate receptor (P2Y12) important in promoting platelet aggregation and cross-linking of platelets by fibrin. The dosage used is 75–100 mg/day, with a half-life of 8 h. Many patients receive a combination of antiplatelet drugs, e.g. aspirin and clopidogrel 4–6; this has been shown to have a synergistic antiplatelet action, with the risk of bleeding complications much greater for combined therapy than for single-drug therapy.

      The fear of uncontrolled or excessive bleeding has prompted dental practitioners to cease or alter the use of these drugs before extraction.  Several studies have demonstrated the risk of thrombosis and myocardial infarction after withdrawal of antiplatelet drugs.