[Retrospective assessment of anti-coagulative therapy and the incidence of acute coronary syndrome during perioperative period in high-risk patients who had suffered percutaneous coronary intervention recently].
OBJECTIVE
To analyze the relationship between early anti-coagulative therapy and acute coronary syndrome (ACS) in the high-risk patients who have suffered percutaneous coronary intervention (PCI) recently during perioperative period of non-cardiac surgery.


METHODS
Patients who underwent scheduled non-cardiac surgery in our hospital from May 2009 to May 2011 were reviewed, of whom, 135 patients had suffered PCI therapy within 1 year, insisting on the treatment by taking aspirin and clopidogrel (plaix) orally. These patients were administrated with heparin replacement treatment before scheduled surgeries. After surgeries, patients were divided into non-anticoagulative therapy group (63 cases), low molecular weight heparin (LMWH)-anticoagulative therapy group (36 cases) and unfractionated heparin (UFH)-anticoagulative therapy group (38 cases). The occurrence of ACS and hemorrhage in 3 days after operations was evaluated.


RESULTS
Of the 135 patients, 9 developed ACS in 3 days in non-anticoagulative therapy group and none in other 2 groups (P<0.01). No statistical difference among the 3 groups in quantity of the blood transfusion was found.


CONCLUSIONS
After scheduled non-cardiac surgeries, early and effective anticoagulative therapy administrated in the high-risk patients who have suffered PCI recently can obviously lower peri-operative incidence of acute coronary syndrome, and can be incapable of increasing risk of post-operative hemorrhage.
Department of Surgical Intensive Care Unit, Capital University of Medical Sciences, Beijing, China. Cancer_sun@hotmail.com
Jian-ping
JP
Sun
Jing-lan
JL
Zhang
D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D002763:Cholecystectomy; D003327:Coronary Disease / Q000150:complications* / Q000628:therapy; D005260:Female; D005705:Gallbladder Diseases / Q000150:complications / Q000601:surgery*; D005743:Gastrectomy; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D019990:Perioperative Care; D059035:Perioperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D013272:Stomach Diseases / Q000150:complications / Q000601:surgery*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight