Use of Antiplatelet Therapy/DAPT for Post-PCI Patients Undergoing Noncardiac Surgery

Subhash Banerjee, Dominick J. Angiolillo, William E. Boden, Joseph G. Murphy, Houman Khalili, Ahmed A. Hasan, Robert A. Harrington, Sunil V. Rao

Research output: Contribution to journalReview article

17 Citations (Scopus)

Abstract

Dual antiplatelet therapy (DAPT) is prescribed to millions of patients worldwide following coronary stenting. DAPT is indicated to lower the risk of ischemic events, such as myocardial infarction, including stent thrombosis, ischemic stroke, or death from cardiovascular causes. A significant number of these patients undergo noncardiac surgery and may require DAPT interruption. This poses a significant clinical dilemma because DAPT interruption exposes patients to the potential risk of stent thrombosis, perioperative myocardial infarction, or both. Conversely, continuing DAPT may be associated with excess bleeding complications. Observational data in this area are conflicting, and there are no randomized clinical trials to guide practitioner decision making. On the basis of predominantly consensus recommendations, various strategies for managing DAPT during the perioperative period have been proposed. This review presents 3 commonly encountered clinical scenarios that lead into an evidence-based discussion of practical strategies for managing perioperative antiplatelet therapy in patients following percutaneous coronary intervention.

Original languageEnglish (US)
Pages (from-to)1861-1870
Number of pages10
JournalJournal of the American College of Cardiology
Volume69
Issue number14
DOIs
StatePublished - Apr 11 2017

Fingerprint

Therapeutics
Stents
Thrombosis
Myocardial Infarction
Perioperative Period
Percutaneous Coronary Intervention
Cause of Death
Consensus
Decision Making
Randomized Controlled Trials
Stroke
Hemorrhage

Keywords

  • aspirin
  • coronary balloon angioplasty
  • drug-eluting stents
  • risk assessment
  • stents
  • thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Banerjee, S., Angiolillo, D. J., Boden, W. E., Murphy, J. G., Khalili, H., Hasan, A. A., ... Rao, S. V. (2017). Use of Antiplatelet Therapy/DAPT for Post-PCI Patients Undergoing Noncardiac Surgery. Journal of the American College of Cardiology, 69(14), 1861-1870. https://doi.org/10.1016/j.jacc.2017.02.012

Use of Antiplatelet Therapy/DAPT for Post-PCI Patients Undergoing Noncardiac Surgery. / Banerjee, Subhash; Angiolillo, Dominick J.; Boden, William E.; Murphy, Joseph G.; Khalili, Houman; Hasan, Ahmed A.; Harrington, Robert A.; Rao, Sunil V.

In: Journal of the American College of Cardiology, Vol. 69, No. 14, 11.04.2017, p. 1861-1870.

Research output: Contribution to journalReview article

Banerjee, S, Angiolillo, DJ, Boden, WE, Murphy, JG, Khalili, H, Hasan, AA, Harrington, RA & Rao, SV 2017, 'Use of Antiplatelet Therapy/DAPT for Post-PCI Patients Undergoing Noncardiac Surgery', Journal of the American College of Cardiology, vol. 69, no. 14, pp. 1861-1870. https://doi.org/10.1016/j.jacc.2017.02.012
Banerjee, Subhash ; Angiolillo, Dominick J. ; Boden, William E. ; Murphy, Joseph G. ; Khalili, Houman ; Hasan, Ahmed A. ; Harrington, Robert A. ; Rao, Sunil V. / Use of Antiplatelet Therapy/DAPT for Post-PCI Patients Undergoing Noncardiac Surgery. In: Journal of the American College of Cardiology. 2017 ; Vol. 69, No. 14. pp. 1861-1870.
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