title: Incidence and clinical outcome of minor surgery in the year after drug-eluting stent implantation: results from the Evaluation of Drug-Eluting Stents and Ischemic Events Registry.
abstract: BACKGROUND
  The aim of the study was to describe the incidence and consequences of minor surgery after drug-eluting stent (DES) implantation.
  
  
  METHODS
  The Evaluation of Drug-Eluting Stents and Ischemic Events (EVENT) Registry prospectively enrolled unselected patients undergoing percutaneous coronary intervention at 47 US centers between July 2004 and December 2007. We examined 8,323 patients who received a DES in EVENT to determine the frequencies of minor surgery and postoperative adverse events.
  
  
  RESULTS
  Minor surgery (defined as procedures not requiring a major surgical incision) was performed in 164 (2.0%) of 8,323 patients <1 year after stenting, as follows: pacemaker/defibrillator implantation (46%), eye surgery (17%), orthopedic (9%), dermatologic (8%), endovascular (6%), and gastrointestinal procedures (5%). Compared with patients who did not undergo minor surgery, those who did were older, had more comorbidities, had more extensive coronary disease, and were more likely to have received warfarin after stenting. Only 1 (0.6%, 95% CI 0.0%-3.4%) of 164 patients had an event (stent thrombosis causing myocardial infarction) during the first week after minor surgery; this rate was slightly higher than the background rate of ischemic events in the study population (exact mid P = .01). Clopidogrel use at 12 months was similar between patients who did and those who did not undergo minor surgery (65.2% vs 65.5%, P = .95).
  
  
  CONCLUSIONS
  In the EVENT Registry, minor surgery was performed in 2% of patients in the first year after DES implantation. The risk of stent thrombosis during the first week after surgery was increased slightly compared with background rates, but the absolute event rate was low (0.6%).
authors.affiliation: VA North Texas Healthcare System and University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA.
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
authors.forename: David J
authors.initials: DJ
authors.lastname: Cohen
authors.forename: Neal S
authors.initials: NS
authors.lastname: Kleiman
authors.forename: Michael
authors.initials: M
authors.lastname: Pencina
authors.forename: Deborah
authors.initials: D
authors.lastname: Nassif
authors.forename: Jorge
authors.initials: J
authors.lastname: Saucedo
authors.forename: Robert N
authors.initials: RN
authors.lastname: Piana
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Keyes
authors.forename: Chen-Hsing
authors.initials: CH
authors.lastname: Yen
authors.forename: Peter B
authors.initials: PB
authors.lastname: Berger
mesh_terms: D000368:Aged; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013511:Minor Surgical Procedures / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012042:Registries; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome