October 2, 2014Thrombosis and Haemostasis
Perioperative management of oral antiplatelet therapy and clinical outcomes in coronary stent patients undergoing surgery
Why the study?
Does perioperative discontinuation of oral antiplatelet therapy increase MACE or reduce bleeding in patients with coronary stents undergoing surgery?
Population
666 patients with coronary stent(s) undergoing cardiac or non-cardiac surgery
Comparison
Perioperative discontinuation of oral… vs Continuation of oral antiplatelet therapy
Design
Cohort
Follow-up
30 days
Authors
Discussion
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Member takes
Implication
May warrant avoiding perioperative antiplatelet discontinuation in stented patients; leaves open need for RCTs to confirm causality.
Structured PICO
Does perioperative discontinuation of oral antiplatelet therapy increase MACE or reduce bleeding in patients with coronary stents undergoing surgery?
P
Population
666 patients with coronary stent(s) undergoing cardiac or non-cardiac surgery
I
Intervention
Perioperative discontinuation (all or partly) of oral antiplatelet medication(s) before undergoing surgery
C
Comparator
Continuation of oral antiplatelet therapy
O
Outcome
30-day incidence of major adverse cardiac events (MACE), defined as the composite of cardiac death, myocardial infarction (MI) or stroke (efficacy), and 30-day incidence of Bleeding Academic Research Consortium (BARC) bleeding ≥ 2 (safety)composite
Perioperative discontinuation of oral antiplatelet therapy in patients with coronary stents significantly increases the 30-day risk of MACE without offering independent protection against clinically relevant bleeding.
Cite This Study
Musumeci et al. (2014) studied this question.