TY - JOUR
T1 - Incidence and clinical outcome of minor surgery in the year after drug-eluting stent implantation
T2 - Results from the Evaluation of Drug-Eluting Stents and Ischemic Events Registry
AU - Brilakis, Emmanouil S.
AU - Cohen, David J.
AU - Kleiman, Neal S.
AU - Pencina, Michael
AU - Nassif, Deborah
AU - Saucedo, Jorge
AU - Piana, Robert N.
AU - Banerjee, Subhash
AU - Keyes, Michelle J.
AU - Yen, Chen Hsing
AU - Berger, Peter B.
N1 - Funding Information:
Funding for the Evaluation of Drug Eluting Stents and Ischemic Events (EVENT) Registry and its analysis was provided by grants from Millennium Pharmaceuticals and Schering Plough Inc.
PY - 2011/2
Y1 - 2011/2
N2 - Background: The aim of the study was to describe the incidence and consequences of minor surgery after drug-eluting stent (DES) implantation. Methods: The Evaluation of Drug-Eluting Stents and Ischemic Events (EVENT) Registry prospectively enrolled unselected patients undergoing percutaneous coronary intervention at 47 US centers between July 2004 and December 2007. We examined 8,323 patients who received a DES in EVENT to determine the frequencies of minor surgery and postoperative adverse events. Results: Minor surgery (defined as procedures not requiring a major surgical incision) was performed in 164 (2.0%) of 8,323 patients <1 year after stenting, as follows: pacemaker/defibrillator implantation (46%), eye surgery (17%), orthopedic (9%), dermatologic (8%), endovascular (6%), and gastrointestinal procedures (5%). Compared with patients who did not undergo minor surgery, those who did were older, had more comorbidities, had more extensive coronary disease, and were more likely to have received warfarin after stenting. Only 1 (0.6%, 95% CI 0.0%-3.4%) of 164 patients had an event (stent thrombosis causing myocardial infarction) during the first week after minor surgery; this rate was slightly higher than the background rate of ischemic events in the study population (exact mid P = .01). Clopidogrel use at 12 months was similar between patients who did and those who did not undergo minor surgery (65.2% vs 65.5%, P = .95). Conclusions: In the EVENT Registry, minor surgery was performed in 2% of patients in the first year after DES implantation. The risk of stent thrombosis during the first week after surgery was increased slightly compared with background rates, but the absolute event rate was low (0.6%).
AB - Background: The aim of the study was to describe the incidence and consequences of minor surgery after drug-eluting stent (DES) implantation. Methods: The Evaluation of Drug-Eluting Stents and Ischemic Events (EVENT) Registry prospectively enrolled unselected patients undergoing percutaneous coronary intervention at 47 US centers between July 2004 and December 2007. We examined 8,323 patients who received a DES in EVENT to determine the frequencies of minor surgery and postoperative adverse events. Results: Minor surgery (defined as procedures not requiring a major surgical incision) was performed in 164 (2.0%) of 8,323 patients <1 year after stenting, as follows: pacemaker/defibrillator implantation (46%), eye surgery (17%), orthopedic (9%), dermatologic (8%), endovascular (6%), and gastrointestinal procedures (5%). Compared with patients who did not undergo minor surgery, those who did were older, had more comorbidities, had more extensive coronary disease, and were more likely to have received warfarin after stenting. Only 1 (0.6%, 95% CI 0.0%-3.4%) of 164 patients had an event (stent thrombosis causing myocardial infarction) during the first week after minor surgery; this rate was slightly higher than the background rate of ischemic events in the study population (exact mid P = .01). Clopidogrel use at 12 months was similar between patients who did and those who did not undergo minor surgery (65.2% vs 65.5%, P = .95). Conclusions: In the EVENT Registry, minor surgery was performed in 2% of patients in the first year after DES implantation. The risk of stent thrombosis during the first week after surgery was increased slightly compared with background rates, but the absolute event rate was low (0.6%).
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U2 - 10.1016/j.ahj.2010.09.028
DO - 10.1016/j.ahj.2010.09.028
M3 - Article
C2 - 21315220
AN - SCOPUS:79851481941
VL - 161
SP - 360
EP - 366
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 2
ER -