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Effect of perioperative antiplatelet therapy on outcomes in patients with drug-eluting stents undergoing elective noncardiac surgery

The American Journal of Cardiology Feb 14, 2019

Hong SJ, et al. - In this retrospective analysis of 2,179 patients who had percutaneous coronary interventions between 2005 and 2016 and required elective noncardiac surgery (NCS) after drug-eluting stent (DES) placement, researchers examined the link between perioperative antiplatelet therapy (APT) and outcomes. At 30 days, assessments were made for a net adverse clinical event (NACE), composite of death, myocardial infarction, stent thrombosis, and major bleeding. NCS with discontinuation of APT was reported for 937 (43%) of 2,179 patients. They noted the occurrence of NACE in 10 patients who discontinued APT (1.1%) and 22 patients who continued APT (1.8%), for overall, without significant differences. They also observed no different adjusted NACE event rates between groups for overall NCSs, for NCSs >1, ≤12 months after DES, and for NCSs >12 months after DES. In patients undergoing elective NCS after DES implantation, discontinuation of APT for ≤7 days was possibly not related to higher NACEs 30 days post-surgery, compared with continuation of APT.
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