The timing of surgical interventions following the implantation of coronary drug-eluting stents in patients undergoing gastrointestinal cancer surgery: A multicenter retrospective cohort study

Background The guidelines recommending a minimum deferral of six months for non-cardiac surgeries following drug-eluting stent percutaneous coronary intervention (DES-PCI) do not adequately address the requirements for individuals undergoing gastrointestinal cancer surgery (GCS). We aim to investigate the optimal timing for surgical interventions to maximize patient benefit. Methods The study encompassed 2,501 patients treated from January 2017 to December 2021, all of whom underwent GCS within one year after DES-PCI. We conducted an analysis by comparing the occurrence of Major Adverse Cardiovascular Events (MACEs) within 30 days post-surgery at different time points. Results This study enrolled a total of 2501 participants with meticulously recorded data who underwent DES-PCI and subsequently underwent GCS within one year post-implantation. The incidence rate of MACEs is 14.2%, including MI(5.1%), HF(5.8%), IS(3.2%), Cardiac death(0.2%) across all patients in this study. The threshold probability was determined using the Youden Index, resulting in a value of 0.320, corresponding to a “Time of surgery value” of 87. Significant statistical differences were observed in the occurrence rates of MACEs for adjacent time intervals at 30 days (p < 0.001), 90 days (p < 0.009), and 180 days (p < 0.001). Conclusions The timing of surgical intervention following DES-PCI significantly influences the occurrence of MACEs at 1 month, 3 months, and 6 months. GCS may be appropriately advanced within the 6-month timeframe, but with the exception of emergency, efforts should be made to defer them beyond the initial month.