Why the study?
Does continuation of thienopyridine antiplatelet therapy prevent postoperative death in patients undergoing elective noncardiac surgery within 90 days of coronary stenting?
Does continuation of thienopyridine antiplatelet therapy prevent postoperative death in patients undergoing elective noncardiac surgery within 90 days of coronary stenting?
Discontinuing thienopyridine antiplatelet therapy for noncardiac surgery within 3 weeks of coronary stenting is associated with a high risk of postoperative death, likely due to stent thrombosis.
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Thienopyridine discontinuation within 3 weeks of stenting was associated with high postoperative mortality; leaves open optimal perioperative DAPT timing in prospective studies.
The optimal timing for elective noncardiac surgery (NCS) after coronary stenting is uncertain. We identified 47 patients who underwent elective NCS within 90 days of coronary stent placement between January 1995 and December 2000. Twenty-seven patients had NCS within 3 weeks of coronary stenting. Six of the seven in whom thienopyridine antiplatelet therapy was discontinued died postoperatively in a manner suggestive of stent thrombosis. In contrast, only 1 of the 20 patients in whom the thienopyridine was continued through the NCS died. The frequency of perioperative hemorrhage was similar whether or not the antiplatelet agent was continued. Only 1 perioperative death occurred in the 20 patients with NCS more than 3 weeks following stenting.
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Sharma et al. (2004) studied this question.
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