Adverse cardiac events in patients with coronary stents undergoing noncardiac surgery: a systematic review

Management of antiplatelet therapy in patients with coronary stents undergoing noncardiac surgery: association with adverse events

“…7e12 This is supported by a systematic review of the literature showing that the rate of perioperative major cardiac events in patients with DES is higher when performed during the first yr postimplantation than afterwards (0%-18% us 0%e12%, respectively). 13 The incremental risk of adverse cardiac events after noncardiac surgery among post-stent patients is highest in the initial six months after implantation and stabilizes at 1% after this period. 14 In the event that the surgery cannot be postponed beyond the recommended time for dual APT, there is no general consensus on the optimal time for the discontinuation of dual APT preoperatively.…”

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

“…Although the possibility for in-hospital death was estimated to be three times higher for the right-sided pneumonectomy compared to lobectomy or limited lung resection, the risk of death following pneumonectomy or extended resection was not correlated to FEV which was not the case for lobectomy (114). Also, the positive cardiologic history is not a risk factor for increased postoperative morbidity and mortality for the elderly, on the assumption that lung resections will be limited to lobar, segmental or wedge resections (104,106,115,116). However, surgery for both middle and lower lobectomy (bilobectomy) was associated with significant cardio-respiratory postoperative complications compared to lower lobectomy (117).…”

“…In case of prior coronary arterial stenting, LC resection is recommended one year after stent's placement because of significant risk for mortality attributed to perioperative major adverse cardiac events (103,104) such as stent thrombosis (103) and MI necessitating revascularization (103). Nevertheless, if coronary stenting occurs and LC surgery must be performed, the following options exist: (I) delay of the oncologic operation; (II) lung resection under cessation of dual anti-platelet therapy or under anti-coagulative treatment by inducing increased risk for perioperative bleeding; and (III) application of stereotactic radiotherapy (105)(106)(107).…”

Risk factors for cardiovascular events and bleeding complications following non-cardiac surgery or procedure in patients with drug eluting stent placement

“…Likewise, some studies report time between stent placement and surgery as the main determinant of outcome 9 13 18. In a recent systematic review describing the results of 28 carefully selected studies (out of 358), the authors concluded that there was enough evidence to support a significant decrease in major adverse cardiac events when surgery was performed more than 1 year after DES placement 19. No conclusive evidence was found to demonstrate the benefit of continuing perioperative antiplatelet therapy 19…”