Incidence and clinical outcome of minor surgery in the year after drug-eluting stent implantation: Results from the Evaluation of Drug-Eluting Stents and Ischemic Events Registry

Emmanouil S. Brilakis, David J. Cohen, Neal S. Kleiman, Michael Pencina, Deborah Nassif, Jorge Saucedo, Robert N. Piana, Subhash Banerjee, Michelle J. Keyes, Chen Hsing Yen, Peter B. Berger

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Abstract

Background: The aim of the study was to describe the incidence and consequences of minor surgery after drug-eluting stent (DES) implantation. Methods: The Evaluation of Drug-Eluting Stents and Ischemic Events (EVENT) Registry prospectively enrolled unselected patients undergoing percutaneous coronary intervention at 47 US centers between July 2004 and December 2007. We examined 8,323 patients who received a DES in EVENT to determine the frequencies of minor surgery and postoperative adverse events. Results: Minor surgery (defined as procedures not requiring a major surgical incision) was performed in 164 (2.0%) of 8,323 patients <1 year after stenting, as follows: pacemaker/defibrillator implantation (46%), eye surgery (17%), orthopedic (9%), dermatologic (8%), endovascular (6%), and gastrointestinal procedures (5%). Compared with patients who did not undergo minor surgery, those who did were older, had more comorbidities, had more extensive coronary disease, and were more likely to have received warfarin after stenting. Only 1 (0.6%, 95% CI 0.0%-3.4%) of 164 patients had an event (stent thrombosis causing myocardial infarction) during the first week after minor surgery; this rate was slightly higher than the background rate of ischemic events in the study population (exact mid P = .01). Clopidogrel use at 12 months was similar between patients who did and those who did not undergo minor surgery (65.2% vs 65.5%, P = .95). Conclusions: In the EVENT Registry, minor surgery was performed in 2% of patients in the first year after DES implantation. The risk of stent thrombosis during the first week after surgery was increased slightly compared with background rates, but the absolute event rate was low (0.6%).

Original languageEnglish (US)
Pages (from-to)360-366
Number of pages7
JournalAmerican Heart Journal
Volume161
Issue number2
DOIs
StatePublished - Feb 2011

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Minor Surgical Procedures
Drug-Eluting Stents
Registries
Incidence
clopidogrel
Stents
Thrombosis
Defibrillators
Warfarin
Percutaneous Coronary Intervention
Orthopedics
Coronary Disease
Comorbidity
Myocardial Infarction
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Incidence and clinical outcome of minor surgery in the year after drug-eluting stent implantation : Results from the Evaluation of Drug-Eluting Stents and Ischemic Events Registry. / Brilakis, Emmanouil S.; Cohen, David J.; Kleiman, Neal S.; Pencina, Michael; Nassif, Deborah; Saucedo, Jorge; Piana, Robert N.; Banerjee, Subhash; Keyes, Michelle J.; Yen, Chen Hsing; Berger, Peter B.

In: American Heart Journal, Vol. 161, No. 2, 02.2011, p. 360-366.

Research output: Contribution to journalArticle

Brilakis, Emmanouil S. ; Cohen, David J. ; Kleiman, Neal S. ; Pencina, Michael ; Nassif, Deborah ; Saucedo, Jorge ; Piana, Robert N. ; Banerjee, Subhash ; Keyes, Michelle J. ; Yen, Chen Hsing ; Berger, Peter B. / Incidence and clinical outcome of minor surgery in the year after drug-eluting stent implantation : Results from the Evaluation of Drug-Eluting Stents and Ischemic Events Registry. In: American Heart Journal. 2011 ; Vol. 161, No. 2. pp. 360-366.
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abstract = "Background: The aim of the study was to describe the incidence and consequences of minor surgery after drug-eluting stent (DES) implantation. Methods: The Evaluation of Drug-Eluting Stents and Ischemic Events (EVENT) Registry prospectively enrolled unselected patients undergoing percutaneous coronary intervention at 47 US centers between July 2004 and December 2007. We examined 8,323 patients who received a DES in EVENT to determine the frequencies of minor surgery and postoperative adverse events. Results: Minor surgery (defined as procedures not requiring a major surgical incision) was performed in 164 (2.0{\%}) of 8,323 patients <1 year after stenting, as follows: pacemaker/defibrillator implantation (46{\%}), eye surgery (17{\%}), orthopedic (9{\%}), dermatologic (8{\%}), endovascular (6{\%}), and gastrointestinal procedures (5{\%}). Compared with patients who did not undergo minor surgery, those who did were older, had more comorbidities, had more extensive coronary disease, and were more likely to have received warfarin after stenting. Only 1 (0.6{\%}, 95{\%} CI 0.0{\%}-3.4{\%}) of 164 patients had an event (stent thrombosis causing myocardial infarction) during the first week after minor surgery; this rate was slightly higher than the background rate of ischemic events in the study population (exact mid P = .01). Clopidogrel use at 12 months was similar between patients who did and those who did not undergo minor surgery (65.2{\%} vs 65.5{\%}, P = .95). Conclusions: In the EVENT Registry, minor surgery was performed in 2{\%} of patients in the first year after DES implantation. The risk of stent thrombosis during the first week after surgery was increased slightly compared with background rates, but the absolute event rate was low (0.6{\%}).",
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T1 - Incidence and clinical outcome of minor surgery in the year after drug-eluting stent implantation

T2 - Results from the Evaluation of Drug-Eluting Stents and Ischemic Events Registry

AU - Brilakis, Emmanouil S.

AU - Cohen, David J.

AU - Kleiman, Neal S.

AU - Pencina, Michael

AU - Nassif, Deborah

AU - Saucedo, Jorge

AU - Piana, Robert N.

AU - Banerjee, Subhash

AU - Keyes, Michelle J.

AU - Yen, Chen Hsing

AU - Berger, Peter B.

PY - 2011/2

Y1 - 2011/2

N2 - Background: The aim of the study was to describe the incidence and consequences of minor surgery after drug-eluting stent (DES) implantation. Methods: The Evaluation of Drug-Eluting Stents and Ischemic Events (EVENT) Registry prospectively enrolled unselected patients undergoing percutaneous coronary intervention at 47 US centers between July 2004 and December 2007. We examined 8,323 patients who received a DES in EVENT to determine the frequencies of minor surgery and postoperative adverse events. Results: Minor surgery (defined as procedures not requiring a major surgical incision) was performed in 164 (2.0%) of 8,323 patients <1 year after stenting, as follows: pacemaker/defibrillator implantation (46%), eye surgery (17%), orthopedic (9%), dermatologic (8%), endovascular (6%), and gastrointestinal procedures (5%). Compared with patients who did not undergo minor surgery, those who did were older, had more comorbidities, had more extensive coronary disease, and were more likely to have received warfarin after stenting. Only 1 (0.6%, 95% CI 0.0%-3.4%) of 164 patients had an event (stent thrombosis causing myocardial infarction) during the first week after minor surgery; this rate was slightly higher than the background rate of ischemic events in the study population (exact mid P = .01). Clopidogrel use at 12 months was similar between patients who did and those who did not undergo minor surgery (65.2% vs 65.5%, P = .95). Conclusions: In the EVENT Registry, minor surgery was performed in 2% of patients in the first year after DES implantation. The risk of stent thrombosis during the first week after surgery was increased slightly compared with background rates, but the absolute event rate was low (0.6%).

AB - Background: The aim of the study was to describe the incidence and consequences of minor surgery after drug-eluting stent (DES) implantation. Methods: The Evaluation of Drug-Eluting Stents and Ischemic Events (EVENT) Registry prospectively enrolled unselected patients undergoing percutaneous coronary intervention at 47 US centers between July 2004 and December 2007. We examined 8,323 patients who received a DES in EVENT to determine the frequencies of minor surgery and postoperative adverse events. Results: Minor surgery (defined as procedures not requiring a major surgical incision) was performed in 164 (2.0%) of 8,323 patients <1 year after stenting, as follows: pacemaker/defibrillator implantation (46%), eye surgery (17%), orthopedic (9%), dermatologic (8%), endovascular (6%), and gastrointestinal procedures (5%). Compared with patients who did not undergo minor surgery, those who did were older, had more comorbidities, had more extensive coronary disease, and were more likely to have received warfarin after stenting. Only 1 (0.6%, 95% CI 0.0%-3.4%) of 164 patients had an event (stent thrombosis causing myocardial infarction) during the first week after minor surgery; this rate was slightly higher than the background rate of ischemic events in the study population (exact mid P = .01). Clopidogrel use at 12 months was similar between patients who did and those who did not undergo minor surgery (65.2% vs 65.5%, P = .95). Conclusions: In the EVENT Registry, minor surgery was performed in 2% of patients in the first year after DES implantation. The risk of stent thrombosis during the first week after surgery was increased slightly compared with background rates, but the absolute event rate was low (0.6%).

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