Adverse cardiac events in patients with coronary stents undergoing noncardiac surgery: a systematic review

被引：19
|
作者：
Hollis, Robert H. [1 ,2 ]
Graham, Laura A. [1 ]
Richman, Joshua S. [1 ,2 ]
Deierhoi, Rhiannon J. [1 ,2 ]
Hawn, Mary T. [1 ,2 ]
机构：
[1] Vet Affairs Med Ctr, Ctr Surg Med Acute Care Res & Transit, Birmingham, AL USA
[2] Univ Alabama Birmingham, Dept Surg, Sect Gastrointestinal Surg, Birmingham, AL 35294 USA
来源：
AMERICAN JOURNAL OF SURGERY | 2012年 / 204卷 / 04期
关键词：
Drug-eluting stent; Surgery; Coronary stent; Cardiac events; Surgical outcomes; Antiplatelet therapy; DRUG-ELUTING STENTS; BARE-METAL STENT; RANDOMIZED CLINICAL-TRIALS; ANTIPLATELET THERAPY; LATE THROMBOSIS; MYOCARDIAL-INFARCTION; PERIOPERATIVE PERIOD; RISK; IMPLANTATION; CLOPIDOGREL;
D O I：
10.1016/j.amjsurg.2012.04.008
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
BACKGROUND: When patients with drug-eluting stents (DES) present for surgery, current guidelines recommend delaying elective surgeries until 1 year of dual antiplatelet therapy has been completed. METHODS: We performed a systematic literature review of the major adverse cardiac events (MACE) associated with noncardiac surgery in patients with DES. RESULTS: Twenty-eight of 358 studies met inclusion criteria. Overall, MACE rates decreased as time to surgery increased and varied from 0% to 18% for surgeries within 1 year as compared with 0% to 12% for surgery more than 1 year after a stent. In addition, the current literature showed limited evidence for a protective effect of continuing perioperative dual antiplatelet therapy on MACE rates. CONCLUSIONS: The current literature supports a significant decrease in MACE when surgery is performed 1 year after DES placement; however, the level of evidence is weak. Larger studies are needed to determine the safe interval for surgery after stent placement. Published by Elsevier Inc.
引用
收藏
页码：494 / 501
页数：8
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