Thursday, 7 November 2013

Risk of Major Adverse Cardiac Events Following Noncardiac Surgery in Patients with Coronary Stents. JAMA October 2013

This article looks at the risk factors for adverse cardiac events in patients who have had a coronary stent within 2 years prior to undergoing non-cardiac surgery. Its findings question the current guideline recommendation of delaying elective non-cardiac surgery for 1 year after drug eluting stent placement and 6 weeks after bare metal stent placement. Over 25,000 operations occurring 6 weeks or more after stent placement were included in this study. The investigators found that the 3 most important risks for a Major Adverse Cardiac Event (MACE) occurring in these patients are emergency surgery, history of myocardial infarction in the last 6 months and advanced cardiac disease. Stent type and timing of surgery after 6 months did not seem to be significantly associated with increased MACE, nor did cessation of anti-platelet therapy. Well designed studies are needed on this subject to help guide management of these patients.

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