title: Adverse cardiac events in patients with coronary stents undergoing noncardiac surgery: a systematic review.
abstract: BACKGROUND
  When patients with drug-eluting stents (DES) present for surgery, current guidelines recommend delaying elective surgeries until 1 year of dual antiplatelet therapy has been completed.
  
  
  METHODS
  We performed a systematic literature review of the major adverse cardiac events (MACE) associated with noncardiac surgery in patients with DES.
  
  
  RESULTS
  Twenty-eight of 358 studies met inclusion criteria. Overall, MACE rates decreased as time to surgery increased and varied from 0% to 18% for surgeries within 1 year as compared with 0% to 12% for surgery more than 1 year after a stent. In addition, the current literature showed limited evidence for a protective effect of continuing perioperative dual antiplatelet therapy on MACE rates.
  
  
  CONCLUSIONS
  The current literature supports a significant decrease in MACE when surgery is performed 1 year after DES placement; however, the level of evidence is weak. Larger studies are needed to determine the safe interval for surgery after stent placement.
authors.affiliation: Center for Surgical, Medical Acute Care Research and Transitions, Veteran's Affairs Medical Center, Birmingham, Alabama, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Hollis
authors.forename: Laura A
authors.initials: LA
authors.lastname: Graham
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Richman
authors.forename: Rhiannon J
authors.initials: RJ
authors.lastname: Deierhoi
authors.forename: Mary T
authors.initials: MT
authors.lastname: Hawn
mesh_terms: D003328:Coronary Thrombosis / Q000209:etiology / Q000517:prevention & control*; D054855:Drug-Eluting Stents; D017558:Elective Surgical Procedures / Q000009:adverse effects; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D013997:Time Factors
chemical_list: D010975:Platelet Aggregation Inhibitors