title: Cardiac events after non-cardiac surgery in patients with previous coronary intervention in the drug-eluting stent era.
abstract: The peri-operative risk for patients with coronary drug-eluting stents (DES) who subsequently have non-cardiac surgery (NCS) is unclear. We performed this retrospective study of all patients in our institution who had coronary intervention and subsequent NCS from 2003 through December 2008 to evaluate the incidence of major adverse cardiac events (MACE) in patients who received DES compared to those who received bare-metal stents (BMS) or had percutaneous transluminal coronary angioplasty (PTCA) during the same time period. The main outcome measures were 30-day post-operative myocardial infarction, stent thrombosis, target vessel revascularization (TVR) and cardiac death. During the 6-year study period, 1,770 coronary interventions were performed and 238 patients subsequently had NCS in 8 days to 49 months. Eighteen patients had PTCA, 79 BMS and 141 DES. Acute myocardial infarction occurred in 1 patient who had PTCA, 2 who had BMS and 14 who had DES (p = 0.10). Stent thrombosis occurred in 6 patients who had DES and none who had BMS (p = 0.09). Seven patients who had DES had TVR compared to 1 patient who had BMS and none who had PTCA (p = 0.41). Cardiac mortality occurred in 2 patients who had DES and none who had PTCA or BMS (p = 0.35). In conclusion, the 30-day MACE in patients who received coronary DES and undergone NCS were not significantly different compared to those who received BMS or had PTCA only, with a trend toward higher stent thrombosis in the DES group.
authors: Krannert Institute of Cardiology, Roudebush VA Medical Center, Indiana University School of Medicine, Indianapolis, IN 46202, USA. ibolad@iupui.edu
authors: Islam A
authors: IA
authors: Bolad
authors: Ahmad
authors: A
authors: Alqaqa'a
authors: Bilal
authors: B
authors: Khan
authors: Sudesh K
authors: SK
authors: Srivastav
authors: Elisabeth
authors: E
authors: von der Lohe
authors: Saihari
authors: S
authors: Sadanandan
authors: Jeffrey A
authors: JA
authors: Breall
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000628:therapy; D003643:Death; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D013502:General Surgery; D006801:Humans; D015994:Incidence; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology*; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D013927:Thrombosis / Q000453:epidemiology*; D016896:Treatment Outcome
chemical_list: D008670:Metals