Document Detail

Outcome of Non-Cardiac Surgery After Stent Implantation in the DES Era: Results of the Surgery After Stent (SAS) Registry.
MedLine Citation:
PMID:  21297198     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: 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.
Marta Francesca Brancati; Maura Giammarinaro; Francesco Burzotta; Carlo Trani; Santiago Federico Coroleu; Italo Porto; Antonella Tommasino; Antonio Maria Leone; Giampaolo Niccoli; Rocco Mongiardo; Mario Attilio Mazzari; Giovanni Schiavoni; Filippo Crea
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  23     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  44-9     Citation Subset:  IM    
Via Prati Fiscali 158, 00141 Rome, Italy.
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