title: Outcome of non-cardiac surgery after stent implantation in the DES era: results of the Surgery After Stent (SAS) registry.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Marta Francesca
authors.initials: MF
authors.lastname: Brancati
authors.forename: Maura
authors.initials: M
authors.lastname: Giammarinaro
authors.forename: Francesco
authors.initials: F
authors.lastname: Burzotta
authors.forename: Carlo
authors.initials: C
authors.lastname: Trani
authors.forename: Santiago Federico
authors.initials: SF
authors.lastname: Coroleu
authors.forename: Italo
authors.initials: I
authors.lastname: Porto
authors.forename: Antonella
authors.initials: A
authors.lastname: Tommasino
authors.forename: Antonio Maria
authors.initials: AM
authors.lastname: Leone
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Niccoli
authors.forename: Rocco
authors.initials: R
authors.lastname: Mongiardo
authors.forename: Mario Attilio
authors.initials: MA
authors.lastname: Mazzari
authors.forename: Giovanni
authors.initials: G
authors.lastname: Schiavoni
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D003251:Constriction, Pathologic / Q000517:prevention & control; D054855:Drug-Eluting Stents; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control; D017063:Outcome Assessment, Health Care; D059035:Perioperative Period; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D015607:Stents; D013514:Surgical Procedures, Operative / Q000009:adverse effects
chemical_list: D010975:Platelet Aggregation Inhibitors