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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Vicenzi, MN; Meislitzer, T; Heitzinger, B; Halaj, M; Fleisher, LA; Metzler, H.
Coronary artery stenting and non-cardiac surgery--a prospective outcome study.
Br J Anaesth. 2006; 96(6):686-693
Doi: 10.1093/bja/ael083
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- Leading authors Med Uni Graz
- Vicenzi Martin
- Co-authors Med Uni Graz
- Meislitzer Thomas
- Metzler Helfried
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- Abstract:
- Background. A 45% complication rate and a mortality of 20% were reported previously in patients undergoing non-cardiac surgery after coronary artery stenting. Discontinuation of antiplatelet drugs appeared to be of major influence on outcome. Therefore we undertook a prospective, observational multicentre study with predefined heparin therapy and antiplatelet medication in patients undergoing non-cardiac procedures after coronary artery stenting. Methods: One hundred and three patients from the medical institutions were enrolled prospectively. Patients received coronary artery stents within 1 yr before non-cardiac surgery (urgent, semi-urgent or elective). Antiplatelet drug therapy was not, or only briefly, interrupted. Heparin was administered to all patients. All patients were on an intensive/intermediate care unit after surgery. Main outcome was the combined (cardiac, bleeding, surgical, sepsis) complication rate. Results. Of 103 patients, 44.7% (95% CI 34.9-54.8) suffered complications after surgery; 4.9% (95% CI 1.6-11.0) of the patients died. All but two (bleeding only) adverse events were of cardiac nature. The majority of complications occurred early after surgery. The risk of suffering an event was 2.11-fold greater in patients with recent stents (< 35 days before surgery) as compared with percutaneous cardiac intervention more than 90 days before surgery. Conclusions. Despite heparin and despite having all patients on intensive/intermediate care units, cardiac events are the major cause for new perioperative morbidity/mortality in patients undergoing non-cardiac surgery after coronary artery stenting. The complication rate exceeds the re-occlusion rate of stents in patients without surgery (usually < 1% annually). Patients with coronary artery stenting less than 35 days before surgery are at the greatest risk.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Aged, 80 and over -
- Angioplasty, Balloon, Coronary -
- Blood Loss, Surgical -
- Coronary Stenosis - therapy
- Coronary Thrombosis - prevention & control
- Female -
- Heparin - therapeutic use
- Humans -
- Male -
- Middle Aged -
- Perioperative Care - methods
- Platelet Aggregation Inhibitors - adverse effects Platelet Aggregation Inhibitors - therapeutic use
- Postoperative Complications -
- Prospective Studies -
- Stents - adverse effects
- Surgical Procedures, Operative -
- Time Factors -
- Treatment Outcome -
- Find related publications in this database (Keywords)
- complications
- stent thrombosis
- procedure
- percutaneous coronary intervention (PCI)
- risk
- perioperative