Optimal management of patients needing non-cardiac surgery after coronary stenting has not been established. Objective. To assess the perioperative outcome of patients undergoing non-cardiac surgery after coronary bare-metal stent (BMS) or drug-eluting stent (DES) implantation. METHODS: We enrolled consecutive patients undergoing non-cardiac surgery (up to 2008) after coronary stenting in a single-center registry, prospectively registering clinical and procedural data about revascularization and retrospectively recording surgical details, perioperative therapy and in-hospital outcome after surgery. At our institution, we implant BMS for planned surgery at time of revascularization, and use antiplatelet therapy for surgery required within 1 month of BMS or within 12 months of DES implantation. The primary endpoint was defined as perioperative occurrence of major adverse events, both cardiovascular (death, myocardial infarction, stent thrombosis and repeated revascularization) and hemorrhagic (bleeding requiring transfusions or surgical hemostasis). RESULTS: We enrolled 101 patients: 70 treated with BMS (group 1) and 31 with DES (group 2). The mean interval between stenting and surgery was 288 days. The average number of antiplatelet drugs used during the operative period was higher in group 2 than group 1 (p = 0.02). Fifteen patients (15%) experienced major adverse events (5.9% had non-ST elevation myocardial infarction, 12% received blood transfusions), without a significant difference between the two groups (p = 0.72). At multivariate analysis, the predictor of primary endpoint was time interval between stenting and surgery (p = 0.022). CONCLUSION: We found similar outcomes for non-cardiac surgery after coronary stenting when BMS were selected for planned surgery and dual antiplatelet therapy was used, if indicated, during the operative period.

Brancati, M. F., Giammarinaro, M., Burzotta, F., Trani, C., Coroleu, S., Porto, I., Tommasino, A., Leone, A. M., Niccoli, G., Mongiardo, R., Mazzari, M. A., Schiavoni, G., Crea, F., Outcome of non-cardiac surgery after stent implantation in the DES era: results of the Surgery After Stent (SAS) registry, <<JOURNAL OF INVASIVE CARDIOLOGY>>, 2011; (23): 44-49 [http://hdl.handle.net/10807/3058]

Outcome of non-cardiac surgery after stent implantation in the DES era: results of the Surgery After Stent (SAS) registry

Brancati, Marta Francesca;Giammarinaro, Maura;Burzotta, Francesco;Trani, Carlo;Porto, Italo;Tommasino, Antonella;Leone, Antonio Maria;Niccoli, Giampaolo;Mongiardo, Rocco;Mazzari, Mario Attilio;Schiavoni, Giovanni;Crea, Filippo
2011

Abstract

Optimal management of patients needing non-cardiac surgery after coronary stenting has not been established. Objective. To assess the perioperative outcome of patients undergoing non-cardiac surgery after coronary bare-metal stent (BMS) or drug-eluting stent (DES) implantation. METHODS: We enrolled consecutive patients undergoing non-cardiac surgery (up to 2008) after coronary stenting in a single-center registry, prospectively registering clinical and procedural data about revascularization and retrospectively recording surgical details, perioperative therapy and in-hospital outcome after surgery. At our institution, we implant BMS for planned surgery at time of revascularization, and use antiplatelet therapy for surgery required within 1 month of BMS or within 12 months of DES implantation. The primary endpoint was defined as perioperative occurrence of major adverse events, both cardiovascular (death, myocardial infarction, stent thrombosis and repeated revascularization) and hemorrhagic (bleeding requiring transfusions or surgical hemostasis). RESULTS: We enrolled 101 patients: 70 treated with BMS (group 1) and 31 with DES (group 2). The mean interval between stenting and surgery was 288 days. The average number of antiplatelet drugs used during the operative period was higher in group 2 than group 1 (p = 0.02). Fifteen patients (15%) experienced major adverse events (5.9% had non-ST elevation myocardial infarction, 12% received blood transfusions), without a significant difference between the two groups (p = 0.72). At multivariate analysis, the predictor of primary endpoint was time interval between stenting and surgery (p = 0.022). CONCLUSION: We found similar outcomes for non-cardiac surgery after coronary stenting when BMS were selected for planned surgery and dual antiplatelet therapy was used, if indicated, during the operative period.
Inglese
Brancati, M. F., Giammarinaro, M., Burzotta, F., Trani, C., Coroleu, S., Porto, I., Tommasino, A., Leone, A. M., Niccoli, G., Mongiardo, R., Mazzari, M. A., Schiavoni, G., Crea, F., Outcome of non-cardiac surgery after stent implantation in the DES era: results of the Surgery After Stent (SAS) registry, <>, 2011; (23): 44-49 [http://hdl.handle.net/10807/3058]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/3058
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