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Coronary stent implantation and adverse cardiac events after surgery
Author(s) -
Thim Troels,
Egholm Gro,
Olesen Kevin Kris Warnakula,
Madsen Morten,
Jensen Svend Eggert,
Jensen Lisette Okkels,
Bøtker Hans Erik,
Kristensen Steen Dalby,
Maeng Michael
Publication year - 2018
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13030
Subject(s) - medicine , adverse effect , coronary stent , cardiology , cardiac surgery , stent , restenosis
Background In the risk assessment of patients considered for non‐cardiac surgery and with recent coronary stent implantation, coronary drug‐eluting stent implantation procedure characteristics may be taken into account. We aimed to evaluate associations between coronary drug‐eluting stent implantation procedure characteristics and the risk of myocardial infarction and all‐cause death within 30 days after non‐cardiac surgery. Design Patients with coronary drug‐eluting stents were identified using the Western Denmark Heart Registry. Surgical procedures performed after stent implantation were detected using the Danish National Patient Registry. We used registry‐based detection of myocardial infarction and all‐cause death. Results Of 22 590 patients treated with drug‐eluting stents between 2005 and 2012, 4046 underwent non‐cardiac surgery within 1 and 12 months after stent implantation. We found no significant association between the risk of myocardial infarction or all‐cause death within 30 days after surgery and number of arteries treated (1 [reference] vs more), number of lesions treated (1 [reference] vs more), segments treated (left main and proximal left anterior descending artery vs other [reference]), total stent length (<20 mm [reference] vs ≥20 mm), number of stents (1 [reference] vs >1) and largest balloon diameter (≥3 mm [reference] vs <3 mm). All‐cause death, but not myocardial infarction, risk was lower among patients treated with first‐generation vs second‐generation stents (odds ratio 0.58). Conclusions We identified no significant associations between stent implantation procedure characteristics and risk of myocardial infarction or all‐cause death among patients undergoing non‐cardiac surgery. All‐cause death was lower with first‐ vs second‐generation drug‐eluting stents.