Clinical outcome of patients undergoing non-cardiac surgery in the two months following coronary stenting.
OBJECTIVE
We sought to determine the frequency and timing of complications at our institution when surgery was performed within two months of coronary stent placement.


BACKGROUND
The optimal delay following coronary stent placement prior to non-cardiac surgery is unknown.


METHODS
We analyzed the Mayo Clinic Percutaneous Coronary Intervention and Surgical databases between 1990 and 2000 and identified 207 patients who underwent surgery in the two months following successful coronary stent placement.


RESULTS
Eight patients (4.0%) died or suffered a myocardial infarction or stent thrombosis. All 8 patients were among the 168 patients (4.8%, 95% confidence interval [CI] 2.1 to 9.2) undergoing surgery six weeks after stent placement; the frequency of these events ranged from 3.8% to 7.1% per week during each of the six weeks. No events occurred in the 39 patients undergoing surgery seven to nine weeks after stent placement (0%, 95% CI 0.0 to 9.0).


CONCLUSIONS
These data suggest that, whenever possible, non-cardiac surgery should be delayed six weeks after stent placement, by which time stents are generally endothelialized, and a course of antiplatelet therapy to prevent stent thrombosis has been completed.
Wilson
Stephanie H
SH
Department of Cardiology, St. Vincent's Hospital, Darlinghurst, Australia.
Fasseas
Panayotis
P
Orford
James L
JL
Lennon
Ryan J
RJ
Horlocker
Terese
T
Charnoff
Nina E
NE
Melby
Steven
S
Berger
Peter B
PB
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D001803:Blood Transfusion / Q000706:statistics & numerical data; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications* / Q000628:therapy*; D003328:Coronary Thrombosis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D011725:Pyridines / Q000627:therapeutic use; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D011725:Pyridines; C446540:thienopyridine; D014859:Warfarin; D001241:Aspirin