{"id":5132,"date":"2012-08-14T00:00:00","date_gmt":"2012-08-14T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/risk-of-elective-major-noncardiac-surgery-after-coronary-stent-insertion-a-population-based-study\/"},"modified":"2023-06-14T19:34:28","modified_gmt":"2023-06-14T23:34:28","slug":"risk-of-elective-major-noncardiac-surgery-after-coronary-stent-insertion-a-population-based-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/risk-of-elective-major-noncardiac-surgery-after-coronary-stent-insertion-a-population-based-study\/","title":{"rendered":"Risk of elective major noncardiac surgery after coronary stent insertion: a population-based study"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; Guidelines recommend that noncardiac surgery be delayed until 30 to 45 days after bare-metal stent implantation and 1 year after drug-eluting stent implantation.<\/p>\n<p><span class=\"bold\">Methods and Results<\/span> &#x2014; We used linked registry data and population-based administrative healthcare databases to conduct a cohort study of 8116 patients (&#x2265;40 years of age) who underwent major elective noncardiac surgery in Ontario, Canada between 2003 and 2009, and received coronary stents within 10 years before surgery. Approximately 34% (n=2725) underwent stent insertion within 2 years before surgery, of whom 905 (33%) received drug-eluting stents. For comparison, we assembled a separate cohort of 341 350 surgical patients who had not undergone coronary revascularization. The primary outcome was 30-day major adverse cardiac events (mortality, readmission for acute coronary syndrome, or repeat coronary revascularization). The overall rate of 30-day events in patients with coronary stents was 2.1% (n=170). When the interval between stent insertion and surgery was &lt;45 days, event rates were high for bare-metal (6.7%) and drug-eluting (20.0%) stents. When the interval was 45 to 180 days, the event rate for bare-metal stents was 2.6%, approaching that of intermediate-risk nonrevascularized individuals. Adjusted analyses suggested that event rates were increased if this interval exceeded 180 days. For drug-eluting stents, the event rate was 1.2% once the interval exceeded 180 days, approaching that of intermediate-risk nonrevascularized individuals.<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; The earliest optimal time for elective surgery is 46 to 180 days after bare-metal stent implantation or &gt;180 days after drug-eluting stent implantation.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; Guidelines recommend that noncardiac surgery be delayed until 30 to 45 days after bare-metal stent implantation and 1 year after drug-eluting stent implantation. Methods and Results &#x2014; We used linked registry data and population-based administrative healthcare databases to conduct a cohort study of 8116 patients (&#x2265;40 years of age) who underwent major elective [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[40,25],"migration-helper-qa-sample-set":[],"class_list":["post-5132","journal_article","type-journal_article","status-publish","hentry","topic-cardiovascular-disease","topic-surgery"],"acf":{"citation":"Wijeysundera DN, Wijeysundera HC, Yun L, W&#x105;sowicz M, Beattie SW, Velianou JL, Ko DT. <em>Circulation<\/em>. 2012; 126(11):1355-62. Epub 2012 Aug 14.","source_url":"http:\/\/circ.ahajournals.org\/content\/126\/11\/1355.long","ices_scientist":[1132,1133,1146],"site":[6733],"research_program":[6742],"news_release":[7491],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"A2165304-3C20-4643-AE54-4A84C466D701","sitecore_item_name":"Risk-of-elective-major-noncardiac-surgery-after-coronary-stent-insertion","sitecore_field_values":"{\n  \"Title\": \"Risk of elective major noncardiac surgery after coronary stent insertion: a population-based study\",\n  \"Short title\": \"Risk of elective major noncardiac\",\n  \"Citation\": \"<p>Wijeysundera DN, Wijeysundera HC, Yun L, W\u0105sowicz M, Beattie SW, Velianou JL, Ko DT. <em>Circulation<\/em>. 2012; 126(11):1355-62. Epub 2012 Aug 14.<\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; Guidelines recommend that noncardiac surgery be delayed until 30 to 45 days after bare-metal stent implantation and 1 year after drug-eluting stent implantation.<\/p>n<p><span class=\"bold\">Methods and Results<\/span> &mdash; We used linked registry data and population-based administrative healthcare databases to conduct a cohort study of 8116 patients (&ge;40 years of age) who underwent major elective noncardiac surgery in Ontario, Canada between 2003 and 2009, and received coronary stents within 10 years before surgery. Approximately 34% (n=2725) underwent stent insertion within 2 years before surgery, of whom 905 (33%) received drug-eluting stents. For comparison, we assembled a separate cohort of 341 350 surgical patients who had not undergone coronary revascularization. The primary outcome was 30-day major adverse cardiac events (mortality, readmission for acute coronary syndrome, or repeat coronary revascularization). The overall rate of 30-day events in patients with coronary stents was 2.1% (n=170). When the interval between stent insertion and surgery was &lt;45 days, event rates were high for bare-metal (6.7%) and drug-eluting (20.0%) stents. When the interval was 45 to 180 days, the event rate for bare-metal stents was 2.6%, approaching that of intermediate-risk nonrevascularized individuals. Adjusted analyses suggested that event rates were increased if this interval exceeded 180 days. For drug-eluting stents, the event rate was 1.2% once the interval exceeded 180 days, approaching that of intermediate-risk nonrevascularized individuals.<\/p>n<p><strong>Conclusions<\/strong> &mdash; The earliest optimal time for elective surgery is 46 to 180 days after bare-metal stent implantation or &gt;180 days after drug-eluting stent implantation.<\/p>n<p><a href=\"http:\/\/circ.ahajournals.org\/content\/126\/11\/1355.long\" title=\"Opens external link\">View full text<\/a><\/p>\",\n  \"Keywords\": \"{9F514AF9-2526-48FE-8414-54C443CF99AD}|{5718D5DE-813C-4BEF-B244-C1252842E4D5}\",\n  \"Related Products\": \"<h2>News Release<\/h2>rn<h3><a href=\"~\/link.aspx?_id=8D4B8ABC13E94DC9876EDB4196206B99&amp;_z=z\">ICES study suggests change in guidelines for elective surgery for people with drug-eluting stents<\/a><\/h3>\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{22E01D03-965E-4F09-9CC2-6BC40EC9403D}|{8C2597F4-2B41-4E87-9F28-6887C689651B}|{B3827152-93D1-4FB2-B106-590CB331A264}\",\n  \"Posted Date\": \"20120814T000000\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2012\/January\/Risk-of-elective-major-noncardiac-surgery-after-coronary-stent-insertion"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Risk of elective major noncardiac surgery after coronary stent insertion: a population-based study<\/title>\n<meta name=\"description\" content=\"Background &#x2014; 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