Cardiac risk of noncardiac surgery after percutaneous coronary intervention with drug-eluting stents

Gregory A. Nuttall, Jennifer A. Rabbitts, Michael J. Brown, Andrew C. Hanson, William C. Oliver, David R. Holmes, Charanjit S. Rihal

Research output: Contribution to journalArticle

176 Scopus citations

Abstract

Background:: The American College of Cardiology released a scientific advisory that included a recommendation to delay elective of noncardiac surgery (NCS) for 1 yr after percutaneous coronary intervention (PCI) with a drug-eluting stent (DES). Methods: This single-center, retrospective study examined the risk for complications of NCS performed within 2 yr after DES placement and examined whether this risk changed based on the time between procedures. The primary endpoint was major adverse cardiac events (MACEs) during the hospitalization for NCS. Bleeding events were analyzed as a secondary endpoint. Results: From April 22, 2003, to December 31, 2006, a total of 520 patients underwent NCS within 2 yr after PCI with a DES at Mayo Clinic. The majority, 84%, of the DES placed were Cypher stents. The frequency of MACE was not found to be significantly associated with the time between PCI and NCS (rate of MACEs 6.4, 5.7, 5.9, and 3.3% at 0-90, 91-180, 181-365, and 366-730 days after PCI with DES, respectively; P = 0.727 for comparison across groups). Characteristics found to be associated with MACEs in univariate analysis were advanced age (P = 0.031), emergent NCS (P = 0.006), shock at time of PCI (P = 0.035), previous history of myocardial infarction (P = 0.046), and continuation of a thienopyridine (ticlopidine or clopidogrel) into the preoperative period (P = 0.040). The rate of transfusion did not seem to be associated with antiplatelet therapy use. Conclusions: The risk of MACEs with NCS after DES placement was not significantly associated with time from stenting to surgery, but observed rates of MACEs were lowest after 1 yr.

Original languageEnglish (US)
Pages (from-to)596-604
Number of pages9
JournalAnesthesiology
Volume109
Issue number4
DOIs
StatePublished - Oct 2008

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Fingerprint Dive into the research topics of 'Cardiac risk of noncardiac surgery after percutaneous coronary intervention with drug-eluting stents'. Together they form a unique fingerprint.

  • Cite this

    Nuttall, G. A., Rabbitts, J. A., Brown, M. J., Hanson, A. C., Oliver, W. C., Holmes, D. R., & Rihal, C. S. (2008). Cardiac risk of noncardiac surgery after percutaneous coronary intervention with drug-eluting stents. Anesthesiology, 109(4), 596-604. https://doi.org/10.1097/ALN.0b013e318186de1c