Cardiovascular and bleeding risk of non-cardiac surgery in patients on antiplatelet therapy

J Cardiol. 2014 Nov;64(5):334-8. doi: 10.1016/j.jjcc.2014.02.027. Epub 2014 May 5.

Abstract

Background: The perioperative risk of non-cardiac surgery (NCS) in the patients on antiplatelet therapy after percutaneous coronary intervention (PCI) remains unclear.

Methods: This study was a retrospective and single center study. Between January 2008 and December 2011, 198 patients who had already received PCI underwent NCS in our hospital. Among them, 63 patients underwent surgery on dual antiplatelet therapy (DAPT group) and 88 patients on single antiplatelet therapy (SAPT group). We compared bleeding events and cardiovascular events during perioperative period between the two groups.

Results: There was no stent thrombosis in either group. The bleeding events in the DAPT group were significantly higher than that in the SAPT group (9.5% vs 2.3%, p=0.049). There was no difference in events between with or without heparin-bridge in the SAPT group.

Conclusions: The frequency of bleeding events was higher in the DAPT group. Both bleeding and cardiovascular events with aspirin alone were low in our study. It may be safe to undergo NCS with SAPT after PCI.

Keywords: Antiplatelet therapy; Bleeding; Heparin-bridge; Non cardiac surgery; Stent thrombosis.

MeSH terms

  • Aged
  • Aspirin / administration & dosage
  • Aspirin / adverse effects
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / epidemiology
  • Female
  • Hemorrhage / chemically induced*
  • Hemorrhage / epidemiology
  • Heparin / administration & dosage
  • Heparin / adverse effects
  • Humans
  • Male
  • Membrane Proteins
  • Middle Aged
  • Percutaneous Coronary Intervention*
  • Perioperative Care / adverse effects*
  • Perioperative Period
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / adverse effects*
  • Retrospective Studies
  • Stents / adverse effects*
  • Time Factors
  • Tumor Suppressor Proteins

Substances

  • Membrane Proteins
  • Platelet Aggregation Inhibitors
  • TMEM158 protein, human
  • Tumor Suppressor Proteins
  • Heparin
  • Aspirin