Document Detail


Frequency and risk of noncardiac surgery after drug-eluting stent implantation.
MedLine Citation:
PMID:  20824750     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Few studies have described the frequency and risk of surgery after drug-eluting stent (DES) implantation.
METHODS: The medical records of 827 consecutive patients who received a DES at our institution between January 1, 2005 and July 1, 2008 were retrospectively reviewed to determine the outcomes of patients who subsequently underwent noncardiac surgery.
RESULTS: During a median follow-up of 21 months, 135 patients underwent 191 noncardiac surgeries. The incidence of noncardiac surgery was 7% at 1 year, 18% at 2 years, and 22% at 3 years. Mean age was 62 years and 96% were men. A perioperative complication occurred in 19 surgeries (10%): excessive bleeding in 11 patients (6%), myocardial infarction in four patients (2%), acute renal failure in one patient (0.5%), hypotension and syncope in one patient (0.5%) and postoperative death in three patients (1.6%). Stent thrombosis occurred in one patient (0.5%). A complication occurred in six of 58 surgeries (10%) in which patients received perioperative clopidogrel vs. 13 of 133 surgeries (10%) in which patients did not receive perioperative clopidogrel (P = 0.90). Complications occurred in three of 25 surgeries performed within 6 months (16%), in four of 37 surgeries performed between 6 and 12 months (11%), and in 12 of 129 surgeries performed after >12 months (9%) from DES implantation (P = 0.90).
CONCLUSION: Noncardiac surgery is frequently needed in the years after DES implantation and appears to carry a low risk of stent thrombosis and perioperative complications.
Authors:
Nainesh K Gandhi; Abdul-Rahman R Abdel-Karim; Subhash Banerjee; Emmanouil S Brilakis
Publication Detail:
Type:  Journal Article     Date:  2011-03-08
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  77     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-20     Completed Date:  2011-09-09     Revised Date:  2012-03-16    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  972-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Wiley-Liss, Inc.
Affiliation:
VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, Texas 75216, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary / adverse effects,  instrumentation*,  mortality
Chi-Square Distribution
Drug-Eluting Stents*
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction / etiology
Platelet Aggregation Inhibitors / administration & dosage
Postoperative Complications / etiology*,  mortality
Retrospective Studies
Risk Assessment
Risk Factors
Surgical Procedures, Operative* / adverse effects,  mortality
Texas
Thrombosis / etiology
Ticlopidine / administration & dosage,  analogs & derivatives
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2012 Feb 15;79(3):498; author reply 499-500   [PMID:  21805612 ]
Catheter Cardiovasc Interv. 2011 Jun 1;77(7):977-8   [PMID:  21598350 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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