Risk of Adverse Cardiac and Bleeding Events Following Cardiac and Noncardiac Surgery in Patients With Coronary Stent
Key result
Surgery in patients with coronary stents increased the risk of cardiac death 1.58-fold during follow-up, with ischemic risk inversely related to time from PCI and influenced by stent type.
Why the study?
Does the type of coronary stent and the timing of surgery after percutaneous coronary intervention affect the risk of adverse cardiac and bleeding events?
Population
39,362 patients with previous coronary stenting enrolled in a multicenter prospective registry, of which…
Comparison
Cardiac and noncardiac surgery at various time… vs Comparisons between different stent types and…
Design
Cohort
Follow-up
5 years; outcomes assessed within 30 days from surgery
Authors
Discussion
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Implication
Surgery after stenting may warrant timing caution; leaves open optimal stent-specific strategies pending prospective trials.
Study Design
Type
Cohort (n=39,362)
Multicenter
Yes
Structured PICO
Does the type of coronary stent and the timing of surgery after percutaneous coronary intervention affect the risk of adverse cardiac and bleeding events?
P
Population
39,362 patients with previous coronary stenting followed for 5 years to assess the incidence and predictors of adverse events following surgery.
E
Exposure
Cardiac and noncardiac surgery at various time intervals after percutaneous coronary intervention with different stent types (bare-metal stent, old-generation drug-eluting stent, new-generation drug-eluting stent).
C
Comparator
Comparisons between different stent types (e.g., new-generation drug-eluting stent vs bare-metal stent) and time intervals from percutaneous coronary intervention to surgery.
O
Outcome
Incidence of cardiac death, myocardial infarction, and serious bleeding event within 30 days from surgery.hard clinical
Main Result
Effect estimate: 1.58x risk
Surgery in patients with prior coronary stenting is common and carries significant ischemic and bleeding risks, which are inversely related to the time from PCI and influenced by stent type, with new-generation DES showing similar or better safety compared to bare-metal stents.
Cite This Study
Saia et al. (2015) conducted a cohort in Previous coronary stenting (n=39,362). Surgery (cardiac and noncardiac) vs. No surgery / different stent types and timing was evaluated on Cardiac death within 30 days from surgery (1.58x risk). Surgery in patients with coronary stents increased the risk of cardiac death 1.58-fold during follow-up, with ischemic risk inversely related to time from PCI and influenced by stent type.