Major noncardiac surgery following coronary stenting: when is it safe to operate?
The optimal timing for elective noncardiac surgery (NCS) after coronary stenting is uncertain. We identified 47 patients who underwent elective NCS within 90 days of coronary stent placement between January 1995 and December 2000. Twenty-seven patients had NCS within 3 weeks of coronary stenting. Six of the seven in whom thienopyridine antiplatelet therapy was discontinued died postoperatively in a manner suggestive of stent thrombosis. In contrast, only 1 of the 20 patients in whom the thienopyridine was continued through the NCS died. The frequency of perioperative hemorrhage was similar whether or not the antiplatelet agent was continued. Only 1 perioperative death occurred in the 20 patients with NCS more than 3 weeks following stenting.
Sharma
Arvind K
AK
Division of Cardiology, Washington Hospital Center, Washington, District of Columbia 20010, USA.
Ajani
Andrew E
AE
Hamwi
Shadi M
SM
Maniar
Parimal
P
Lakhani
Shilen V
SV
Waksman
Ron
R
Lindsay
Joseph
J
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D018570:Risk Assessment; D015607:Stents / Q000009:adverse effects*; D013514:Surgical Procedures, Operative; D013997:Time Factors; D016896:Treatment Outcome