BACKGROUND: Few studies have described the frequency and risk of surgery after drug-eluting stent (DES) implantation. METHODS: The medical records of 827 consecutive patients who received a DES at our institution between January 1, 2005 and July 1, 2008 were retrospectively reviewed to determine the outcomes of patients who subsequently underwent noncardiac surgery. RESULTS: During a median follow-up of 21 months, 135 patients underwent 191 noncardiac surgeries. The incidence of noncardiac surgery was 7% at 1 year, 18% at 2 years, and 22% at 3 years. Mean age was 62 years and 96% were men. A perioperative complication occurred in 19 surgeries (10%): excessive bleeding in 11 patients (6%), myocardial infarction in four patients (2%), acute renal failure in one patient (0.5%), hypotension and syncope in one patient (0.5%) and postoperative death in three patients (1.6%). Stent thrombosis occurred in one patient (0.5%). A complication occurred in six of 58 surgeries (10%) in which patients received perioperative clopidogrel vs. 13 of 133 surgeries (10%) in which patients did not receive perioperative clopidogrel (P = 0.90). Complications occurred in three of 25 surgeries performed within 6 months (16%), in four of 37 surgeries performed between 6 and 12 months (11%), and in 12 of 129 surgeries performed after >12 months (9%) from DES implantation (P = 0.90). CONCLUSION: Noncardiac surgery is frequently needed in the years after DES implantation and appears to carry a low risk of stent thrombosis and perioperative complications.
BACKGROUND: Few studies have described the frequency and risk of surgery after drug-eluting stent (DES) implantation. METHODS: The medical records of 827 consecutive patients who received a DES at our institution between January 1, 2005 and July 1, 2008 were retrospectively reviewed to determine the outcomes of patients who subsequently underwent noncardiac surgery. RESULTS: During a median follow-up of 21 months, 135 patients underwent 191 noncardiac surgeries. The incidence of noncardiac surgery was 7% at 1 year, 18% at 2 years, and 22% at 3 years. Mean age was 62 years and 96% were men. A perioperative complication occurred in 19 surgeries (10%): excessive bleeding in 11 patients (6%), myocardial infarction in four patients (2%), acute renal failure in one patient (0.5%), hypotension and syncope in one patient (0.5%) and postoperative death in three patients (1.6%). Stent thrombosis occurred in one patient (0.5%). A complication occurred in six of 58 surgeries (10%) in which patients received perioperative clopidogrel vs. 13 of 133 surgeries (10%) in which patients did not receive perioperative clopidogrel (P = 0.90). Complications occurred in three of 25 surgeries performed within 6 months (16%), in four of 37 surgeries performed between 6 and 12 months (11%), and in 12 of 129 surgeries performed after >12 months (9%) from DES implantation (P = 0.90). CONCLUSION: Noncardiac surgery is frequently needed in the years after DES implantation and appears to carry a low risk of stent thrombosis and perioperative complications.
Authors: Charles Salters; Bruce Bradley; Richard J Charnigo; Zaman Shah; John Meehan; Ahmed Abdel-Latif; Khaled M Ziada Journal: Catheter Cardiovasc Interv Date: 2015-05-06 Impact factor: 2.692
Authors: Lili Plümer; Moritz Seiffert; Mark Andree Punke; Jan Felix Kersten; Stefan Blankenberg; Christian Zöllner; Martin Petzoldt Journal: Dtsch Arztebl Int Date: 2017-07-10 Impact factor: 5.594
Authors: Sean van Diepen; Pierluigi Tricoci; Mohua Podder; Cynthia M Westerhout; Philip E Aylward; Claes Held; Frans Van de Werf; John Strony; Lars Wallentin; David J Moliterno; Harvey D White; Kenneth W Mahaffey; Robert A Harrington; Paul W Armstrong Journal: J Am Heart Assoc Date: 2015-12-15 Impact factor: 5.501