Cardiac events after non-cardiac surgery in patients with previous coronary intervention in the drug-eluting stent era

The peri-operative risk for patients with coronary drug-eluting stents (DES) who subsequently have non-cardiac surgery (NCS) is unclear. We performed this retrospective study of all patients in our institution who had coronary intervention and subsequent NCS from 2003 through December 2008 to evalua...

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Bibliographic Details
Published in:The Journal of invasive cardiology 2011-07, Vol.23 (7), p.283-286
Main Authors: Bolad, Islam A, Alqaqa'a, Ahmad, Khan, Bilal, Srivastav, Sudesh K, von der Lohe, Elisabeth, Sadanandan, Saihari, Breall, Jeffrey A
Format: Article
Language:English
Subjects:
Aged
Angioplasty, Balloon, Coronary
Coronary Artery Disease - therapy
Death
Drug-Eluting Stents - adverse effects
Female
General Surgery
Humans
Incidence
Male
Metals
Middle Aged
Myocardial Infarction - epidemiology
Postoperative Period
Retrospective Studies
Risk Factors
Stents - adverse effects
Thrombosis - epidemiology
Treatment Outcome
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Summary:The peri-operative risk for patients with coronary drug-eluting stents (DES) who subsequently have non-cardiac surgery (NCS) is unclear. We performed this retrospective study of all patients in our institution who had coronary intervention and subsequent NCS from 2003 through December 2008 to evaluate the incidence of major adverse cardiac events (MACE) in patients who received DES compared to those who received bare-metal stents (BMS) or had percutaneous transluminal coronary angioplasty (PTCA) during the same time period. The main outcome measures were 30-day post-operative myocardial infarction, stent thrombosis, target vessel revascularization (TVR) and cardiac death. During the 6-year study period, 1,770 coronary interventions were performed and 238 patients subsequently had NCS in 8 days to 49 months. Eighteen patients had PTCA, 79 BMS and 141 DES. Acute myocardial infarction occurred in 1 patient who had PTCA, 2 who had BMS and 14 who had DES (p = 0.10). Stent thrombosis occurred in 6 patients who had DES and none who had BMS (p = 0.09). Seven patients who had DES had TVR compared to 1 patient who had BMS and none who had PTCA (p = 0.41). Cardiac mortality occurred in 2 patients who had DES and none who had PTCA or BMS (p = 0.35). In conclusion, the 30-day MACE in patients who received coronary DES and undergone NCS were not significantly different compared to those who received BMS or had PTCA only, with a trend toward higher stent thrombosis in the DES group.
ISSN:1557-2501