Perioperative Antiplatelet Strategy in Patients Undergoing Noncardiac Surgery Within One Year After Percutaneous Coronary Intervention - 20/09/23
, Sanghoon Shin, MD, PhD b, Hyeongsoo Kim, MD c, Jong-Kwan Park, MD c, Seung-Jin Oh, MD c, Sung Gyun Ahn, MD, PhD d, Sungsoo Cho, MD, PhD e, Oh-Hyun Lee, MD f, Jae Youn Moon, MD, PhD g, Hoyoun Won, MD, PhD h, Yongsung Suh, MD, PhD i, Yun-Hyeong Cho, MD, PhD i, Jung Rae Cho, MD, PhD j, Byoung-Kwon Lee, MD, PhD k, Yong-Joon Lee, MD a, Seung-Jun Lee, MD, PhD a, Sung-Jin Hong, MD, PhD a, Dong-Ho Shin, MD a, Chul-Min Ahn, MD, PhD a, Byeong-Keuk Kim, MD, PhD a, Young-Guk Ko, MD, PhD a, Donghoon Choi, MD, PhD a, Myeong-Ki Hong, MD, PhD a, Yangsoo Jang, MD, PhD g, Jung-Sun Kim, MD, PhD a, ⁎ Abstract |
Background |
The optimal antiplatelet therapy (APT) for patients undergoing non-cardiac surgery within 1 year after percutaneous coronary intervention (PCI) is not yet established.
Methods |
Patients who underwent non-cardiac surgery within 1 year after second-generation drug-eluting stent implantation were included from a multicenter prospective registry in Korea. The primary endpoint was 30-day net adverse clinical event (NACE), including all-cause death, major adverse cardiovascular event (MACE), and major bleeding events. Covariate adjustment using propensity score was performed.
Results |
Among 1130 eligible patients, 708 (62.7%) continued APT during non-cardiac surgery. After propensity score adjustment, APT continuation was associated with a lower incidence of NACE (3.7% vs 5.5%; adjusted odds ratio [OR], 0.48; 95% confidence interval [CI], 0.26-0.89; P = .019) and MACE (1.1% vs 1.9%; adjusted OR, 0.35; 95% CI, 0.12-0.99; P = .046), whereas the incidence of major bleeding events was not different between the 2 APT strategies (1.7% vs 2.6%; adjusted OR, 0.61; 95% CI, 0.25-1.50; P = .273).
Conclusions |
The APT continuation strategy was chosen in a substantial proportion of patients and was associated with the benefit of potentially reducing 30-day NACE and MACE with similar incidence of major bleeding events, compared with APT discontinuation. This study suggests a possible benefit of APT continuation in non-cardiac surgery within 1 year of second-generation drug-eluting stent implantation.
Le texte complet de cet article est disponible en PDF.Keywords : Antiplatelet therapy, Net adverse clinical events, Non-cardiac surgery, Percutaneous coronary intervention
Plan
| Funding: This work was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute funded by the Ministry of Health and Welfare, Republic of Korea (No: HI20C1566), a grant from the National Research Foundation of Korea funded by the Korean government (the Ministry of Science and ICT) (No: 2022R1A5A1022977), and the Cardiovascular Research Center (Seoul, Korea). |
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| Conflict of Interest: None. |
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| Authorship: All authors had access to the data and a role in writing this manuscript. |
Vol 136 - N° 10
P. 1026 - octobre 2023 Retour au numéro
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