Clinical outcome of patients undergoing non-cardiac surgery in the two months following coronary stenting. J Am Coll Cardiol 2003 Jul 16;42(2):234-40
Date
07/24/2003Pubmed ID
12875757DOI
10.1016/s0735-1097(03)00622-3Scopus ID
2-s2.0-0038488370 (requires institutional sign-in at Scopus site) 416 CitationsAbstract
OBJECTIVES: We sought to determine the frequency and timing of complications at our institution when surgery was performed within two months of coronary stent placement.
BACKGROUND: The optimal delay following coronary stent placement prior to non-cardiac surgery is unknown.
METHODS: We analyzed the Mayo Clinic Percutaneous Coronary Intervention and Surgical databases between 1990 and 2000 and identified 207 patients who underwent surgery in the two months following successful coronary stent placement.
RESULTS: Eight patients (4.0%) died or suffered a myocardial infarction or stent thrombosis. All 8 patients were among the 168 patients (4.8%, 95% confidence interval [CI] 2.1 to 9.2) undergoing surgery six weeks after stent placement; the frequency of these events ranged from 3.8% to 7.1% per week during each of the six weeks. No events occurred in the 39 patients undergoing surgery seven to nine weeks after stent placement (0%, 95% CI 0.0 to 9.0).
CONCLUSIONS: These data suggest that, whenever possible, non-cardiac surgery should be delayed six weeks after stent placement, by which time stents are generally endothelialized, and a course of antiplatelet therapy to prevent stent thrombosis has been completed.
Author List
Wilson SH, Fasseas P, Orford JL, Lennon RJ, Horlocker T, Charnoff NE, Melby S, Berger PBAuthor
Panayotis Fasseas MD Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAngioplasty, Balloon, Coronary
Anticoagulants
Aspirin
Blood Transfusion
Coronary Angiography
Coronary Disease
Coronary Thrombosis
Female
Humans
Male
Middle Aged
Minnesota
Myocardial Infarction
Platelet Aggregation Inhibitors
Postoperative Hemorrhage
Pyridines
Retrospective Studies
Stents
Surgical Procedures, Operative
Time Factors
Treatment Outcome
Warfarin
