| Characterization of post-operative risk associated with prior drug-eluting stent use. | |
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MedLine Citation:
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PMID: 19539259 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The aim of this study was to assess risk of inpatient surgery at any time after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). BACKGROUND: Risk of adverse events, including stent thrombosis (ST), in patients undergoing surgical procedures with prior DES remains poorly defined. METHODS: Outcomes of consecutive patients having inpatient surgical procedures after PCI with DES, placed from April 28, 2003 until December 31, 2006 at a tertiary-care medical center, were studied. Primary and secondary end points were 30-day post-operative risk of the Academic Research Consortium (ARC) definite and modified probable definitions of ST and combined 30-day post-operative risk of death, nonfatal myocardial infarction (MI), or ST, respectively. Multivariable logistic regression analyses were used to determine independent risk factors. RESULTS: Six hundred six inpatient surgeries on 481 patients with a mean time from PCI to surgery of 1.07 +/- 0.89 years were evaluated. The primary and secondary end points occurred after 11 (2.0%) and 56 (9%) surgeries, respectively. Risk of the combined end point and ST decreased significantly in the first 1 to 6 months after PCI (p < 0.0001 and p < 0.014, respectively); however, risk persisted when time between PCI and surgery was >12 months. Independent correlates of the combined end point include emergency surgery, antecedent MI, the pre-operative use of intravenous heparin, and atherosclerotic lesion length treated with DES. Oral antiplatelet status at time of surgery was not a correlate of events. CONCLUSIONS: Risk of 30-day post-operative adverse events, including ST, remains significantly higher when surgery is performed soon after PCI, while intermediate-term risk extending at least 2 to 3 years remains important. |
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Authors:
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Saif Anwaruddin; Arman T Askari; Hammad Saudye; Lilian Batizy; Penny L Houghtaling; Mohammad Alamoudi; Michael Militello; Kamran Muhammad; Samir Kapadia; Stephen G Ellis |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: JACC. Cardiovascular interventions Volume: 2 ISSN: 1876-7605 ISO Abbreviation: JACC Cardiovasc Interv Publication Date: 2009 Jun |
Date Detail:
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Created Date: 2009-06-22 Completed Date: 2009-08-27 Revised Date: 2012-08-29 |
Medline Journal Info:
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Nlm Unique ID: 101467004 Medline TA: JACC Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 542-9 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH 44195, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Balloon, Coronary / adverse effects*, instrumentation, mortality Databases as Topic Drug-Eluting Stents / adverse effects* Female Humans Logistic Models Male Middle Aged Myocardial Infarction / etiology*, mortality Retrospective Studies Risk Assessment Risk Factors Surgical Procedures, Operative / adverse effects*, mortality Thrombosis / etiology*, mortality Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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