How long should patients wait after a coronary stent, before safely undergoing non-cardiac surgery? In 2 recent observational studies from Mayo, researchers evaluated the risk of perioperative cardiac events (death, MI, stent thrombosis, or repeat revascularization) in patients with bare-metal or drug-eluting stents. Of the 899 with bare-metal stents, the adjusted risk of an in-hospital event was 10.5% (< 1 month post stent), 3.8% (1-3 months), and 2.8% (3+months) (Nuttall et al). Of the 520 with drug-eluting stents, the adjusted risk of an in-hospital perioperative event was approximately 6% (< 1 year post stent) and 3.3% (1-2 years) (Rabbitts et al). These data indicate non-cardiac surgery should delayed at least a month for bare metal stents and at least a year for drug eluting stents, which is consistent with recommendations from the ACC/AHA (Guidelines). If surgery cannot be delayed, these statistics can at least help us objectively evaluate the risks and benefits of our perioperative recommendations.
|
October 23, 2008 |
0 
Share This Post
About the Author: Danielle Scheurer
Danielle Scheurer, MD, MSCR, SFHM is a clinical hospitalist and the Chief Quality Officer at the Medical University of South Carolina in Charleston, South Carolina, where she also serves as Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She is also the President of SHM's Board of Directors and previously served as Physician Editor of The Hospitalist, SHM's monthly newsmagazine.
Categories
Related Posts
July 31, 2020 |
0While all of us see patients who smoke in their 70s or 80s, due to their limited lifespan from COPD, DM, malignancy, etc., and their expressed wishes to continue tobacco, we keep our admonitions to a minimum. We accept our patient has become learned enough through life to make their own decisions and accept whatever […]
November 8, 2019 |
0Do you have a stack of journals piling up on your desk, beside your bed or in your email inbox? In 1950, medical knowledge was estimated to double every 50 years, but now the doubling time is every few months. At this rate, it is impossible to keep up with the literature, but a group […]
June 18, 2018 |
0Fill in the Blanks: Q: “The diagnosis of type 2 MI is associated with a _____ prognosis. ___% of patients will live five years after their diagnosis.” The answer is a) POOR and b) a staggering 40%. I did not know that. However, what I am aware of is the ambiguity around Type 2 MIs and […]
Leave A Comment