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The risk of cardiac complications following noncardiac surgery in patients with drug eluting stents implanted at least six months before surgery
Author(s) -
Assali Abid,
VakninAssa Hana,
Lev Eli,
Bental Tamir,
BenDor Itsik,
Teplitsky Igal,
Brosh David,
Fuchs Shmuel,
Eidelman Leonid,
Battler Alexander,
Kornowski Ran
Publication year - 2009
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.22158
Subject(s) - medicine , perioperative , myocardial infarction , surgery , thrombosis , cardiac surgery , stent , cardiology
Aims : Given the anecdotal reports and case series suggesting that drug‐eluting coronary stents [DES] may be still vulnerable to coronary thrombosis after six months, we sought to assess this risk in patients undergoing non‐cardiac surgery six months after stenting. Methods and Results : Linking the Rabin Medical Centre interventional cardiology database with its non‐cardiac surgical database, we identified 78 patients who underwent DES placement and subsequently [after six months] had noncardiac surgery [15‐vascular, 37‐ abdominal and genitourinary and 26‐others, excluding ophthalmic surgery]. Outcome measures included 30‐day rate of postoperative myocardial infarction (MI), DES‐related thrombosis, and cardiac mortality. Major adverse cardiac events [death and non‐fatal MI] occurred in 6 (7.7%) patients including 2 cardiac deaths (2.6%), 4 (5.1%) non‐fatal myocardial infarctions (MIs). Two patients (2.6%) sustained stent thrombosis [one patient had ‘definite’ and one ‘probable’ stent thrombosis]. All MIs [including stent thrombosis] occurred in the vascular and abdominal surgery group. Two of the MIs events occurred while the patients were on dual antiplatelet agents. In conclusions : Perioperative cardiac events during non cardiac surgery after six months of DES deployment still occur. These cardiac complications [not entirely prevented by continued dual antiplatelet agents] remain a matter of diagnostic and therapeutic challenge and concern. © 2009 Wiley‐Liss, Inc.