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Noncardiac Surgery in Patients With Coronary Artery Stents

Noncardiac Surgery in Patients With Coronary Artery Stents EDITORIAL Noncardiac Surgery in Patients With Coronary Artery Stents HE MANAGEMENT OF PATIENTS WHO UN- Table. Comparison of Guideline Recommendations dergo coronary artery stent implantation for Patients With Coronary Stents (CS) Undergoing and subsequently require noncardiac sur- Noncardiac Surgery (NS) gery is a real and challenging clinical prob- T lem. In 2008, more than 800 000 percu- Recommended taneous coronary procedures were performed in the Deferral Period for United States, with coronary stents implanted in over 96% Elective NS Following CS Implantation of cases. Approximately 5% of patients undergo non- Recommendations cardiac surgery in the 12 months following coronary stent Bare for Antiplatelet Therapy Metal Drug-Eluting When NS Cannot implantation. Guideline Stent, wk Stent, mo Be Deferred Patients undergoing noncardiac surgery following coro- ACCP 6 6 Continue dual antiplatelet therapy nary artery stent implantation are at increased risk of ad- perioperatively. verse cardiovascular events in the perioperative period. ACC 4 12 Continue dual antiplatelet therapy Large-scale retrospective studies have reported an over- where possible. all incidence of death or major adverse cardiac events of If not, continue aspirin and stop 2% to 9%, although the risk seems even higher when sur- clopidogrel or prasugrel 2-4 preoperatively. gery is performed http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Noncardiac Surgery in Patients With Coronary Artery Stents

JAMA Internal Medicine , Volume 172 (14) – Jul 23, 2012

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Publisher
American Medical Association
Copyright
Copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/archinternmed.2012.3025
pmid
22733370
Publisher site
See Article on Publisher Site

Abstract

EDITORIAL Noncardiac Surgery in Patients With Coronary Artery Stents HE MANAGEMENT OF PATIENTS WHO UN- Table. Comparison of Guideline Recommendations dergo coronary artery stent implantation for Patients With Coronary Stents (CS) Undergoing and subsequently require noncardiac sur- Noncardiac Surgery (NS) gery is a real and challenging clinical prob- T lem. In 2008, more than 800 000 percu- Recommended taneous coronary procedures were performed in the Deferral Period for United States, with coronary stents implanted in over 96% Elective NS Following CS Implantation of cases. Approximately 5% of patients undergo non- Recommendations cardiac surgery in the 12 months following coronary stent Bare for Antiplatelet Therapy Metal Drug-Eluting When NS Cannot implantation. Guideline Stent, wk Stent, mo Be Deferred Patients undergoing noncardiac surgery following coro- ACCP 6 6 Continue dual antiplatelet therapy nary artery stent implantation are at increased risk of ad- perioperatively. verse cardiovascular events in the perioperative period. ACC 4 12 Continue dual antiplatelet therapy Large-scale retrospective studies have reported an over- where possible. all incidence of death or major adverse cardiac events of If not, continue aspirin and stop 2% to 9%, although the risk seems even higher when sur- clopidogrel or prasugrel 2-4 preoperatively. gery is performed

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Jul 23, 2012

References