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Risk of non-cardiac surgery after percutaneous coronary intervention with drug-eluting stents
Elective non-cardiac surgery (NCS) should optimally be delayed one year after implantation of a drug-eluting stent (DES). Dual antiplatelet therapy or at least aspirin is recommended to be continued considering the relative risk of stent thrombosis especially during the 4 weeks after DES implantatio...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704017/ https://www.ncbi.nlm.nih.gov/pubmed/29180679 http://dx.doi.org/10.1038/s41598-017-16672-z |
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author | Park, Sun-Kyung Jung, Dhong Eun Jung, Sung Ae Kim, Won Ho Bahk, Jae-Hyon |
author_facet | Park, Sun-Kyung Jung, Dhong Eun Jung, Sung Ae Kim, Won Ho Bahk, Jae-Hyon |
author_sort | Park, Sun-Kyung |
collection | PubMed |
description | Elective non-cardiac surgery (NCS) should optimally be delayed one year after implantation of a drug-eluting stent (DES). Dual antiplatelet therapy or at least aspirin is recommended to be continued considering the relative risk of stent thrombosis especially during the 4 weeks after DES implantation. However, these recommendations were supported by insufficient evidence. We investigated predictors for postoperative major adverse cardiovascular and cerebral event (MACCE) in 1582 patients undergoing non-cardiac surgery after DES implantation. 96 patients (6.1%) developed postoperative MACCE. In the propensity score-matched analysis, aspirin maintenance was not associated with MACCE (odds ratio [OR] 0.78, 95% confidence interval [CI] 0.48–1.27, P = 0.320) and was associated with increased risk of major bleeding (OR 1.84, 95% CI 1.02–3.32, P = 0.044). When patients who underwent NCS within one month after DES implantation were matched with those who underwent NCS thereafter, the risk of MACCE was higher when surgery was done within 30 days after PCI (OR 2.21, 95% CI 1.05–4.66, P = 0.036). Maintenance of aspirin did not decrease MACCE after NCS in patients with DES and only increased the risk of major bleeding. NCS within one month after DES implantation was associated with higher incidence of MACCE. However, prospective trials are required to validate our results. |
format | Online Article Text |
id | pubmed-5704017 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-57040172017-11-30 Risk of non-cardiac surgery after percutaneous coronary intervention with drug-eluting stents Park, Sun-Kyung Jung, Dhong Eun Jung, Sung Ae Kim, Won Ho Bahk, Jae-Hyon Sci Rep Article Elective non-cardiac surgery (NCS) should optimally be delayed one year after implantation of a drug-eluting stent (DES). Dual antiplatelet therapy or at least aspirin is recommended to be continued considering the relative risk of stent thrombosis especially during the 4 weeks after DES implantation. However, these recommendations were supported by insufficient evidence. We investigated predictors for postoperative major adverse cardiovascular and cerebral event (MACCE) in 1582 patients undergoing non-cardiac surgery after DES implantation. 96 patients (6.1%) developed postoperative MACCE. In the propensity score-matched analysis, aspirin maintenance was not associated with MACCE (odds ratio [OR] 0.78, 95% confidence interval [CI] 0.48–1.27, P = 0.320) and was associated with increased risk of major bleeding (OR 1.84, 95% CI 1.02–3.32, P = 0.044). When patients who underwent NCS within one month after DES implantation were matched with those who underwent NCS thereafter, the risk of MACCE was higher when surgery was done within 30 days after PCI (OR 2.21, 95% CI 1.05–4.66, P = 0.036). Maintenance of aspirin did not decrease MACCE after NCS in patients with DES and only increased the risk of major bleeding. NCS within one month after DES implantation was associated with higher incidence of MACCE. However, prospective trials are required to validate our results. Nature Publishing Group UK 2017-11-27 /pmc/articles/PMC5704017/ /pubmed/29180679 http://dx.doi.org/10.1038/s41598-017-16672-z Text en © The Author(s) 2017 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Park, Sun-Kyung Jung, Dhong Eun Jung, Sung Ae Kim, Won Ho Bahk, Jae-Hyon Risk of non-cardiac surgery after percutaneous coronary intervention with drug-eluting stents |
title | Risk of non-cardiac surgery after percutaneous coronary intervention with drug-eluting stents |
title_full | Risk of non-cardiac surgery after percutaneous coronary intervention with drug-eluting stents |
title_fullStr | Risk of non-cardiac surgery after percutaneous coronary intervention with drug-eluting stents |
title_full_unstemmed | Risk of non-cardiac surgery after percutaneous coronary intervention with drug-eluting stents |
title_short | Risk of non-cardiac surgery after percutaneous coronary intervention with drug-eluting stents |
title_sort | risk of non-cardiac surgery after percutaneous coronary intervention with drug-eluting stents |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704017/ https://www.ncbi.nlm.nih.gov/pubmed/29180679 http://dx.doi.org/10.1038/s41598-017-16672-z |
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