Frequency and risk of noncardiac surgery after drug-eluting stent implantation

Nainesh K. Gandhi, Abdul Rahman R Abdel-Karim, Subhash Banerjee, Emmanouil S. Brilakis

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

Background: Few studies have described the frequency and risk of surgery after drug-eluting stent (DES) implantation. Methods: The medical records of 827 consecutive patients who received a DES at our institution between January 1, 2005 and July 1, 2008 were retrospectively reviewed to determine the outcomes of patients who subsequently underwent noncardiac surgery. Results: During a median follow-up of 21 months, 135 patients underwent 191 noncardiac surgeries. The incidence of noncardiac surgery was 7% at 1 year, 18% at 2 years, and 22% at 3 years. Mean age was 62 years and 96% were men. A perioperative complication occurred in 19 surgeries (10%): excessive bleeding in 11 patients (6%), myocardial infarction in four patients (2%), acute renal failure in one patient (0.5%), hypotension and syncope in one patient (0.5%) and postoperative death in three patients (1.6%). Stent thrombosis occurred in one patient (0.5%). A complication occurred in six of 58 surgeries (10%) in which patients received perioperative clopidogrel vs. 13 of 133 surgeries (10%) in which patients did not receive perioperative clopidogrel (P = 0.90). Complications occurred in three of 25 surgeries performed within 6 months (16%), in four of 37 surgeries performed between 6 and 12 months (11%), and in 12 of 129 surgeries performed after >12 months (9%) from DES implantation (P = 0.90). Conclusion: Noncardiac surgery is frequently needed in the years after DES implantation and appears to carry a low risk of stent thrombosis and perioperative complications.

Original languageEnglish (US)
Pages (from-to)972-976
Number of pages5
JournalCatheterization and Cardiovascular Interventions
Volume77
Issue number7
DOIs
StatePublished - Jun 1 2011

Keywords

  • clopidogrel
  • drug-eluting stent
  • noncardiac surgery
  • perioperative risk

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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