Use of Antiplatelet Therapy/DAPT for Post-PCI Patients Undergoing Noncardiac Surgery.


Journal Article (Review)

Dual antiplatelet therapy (DAPT) is prescribed to millions of patients worldwide following coronary stenting. DAPT is indicated to lower the risk of ischemic events, such as myocardial infarction, including stent thrombosis, ischemic stroke, or death from cardiovascular causes. A significant number of these patients undergo noncardiac surgery and may require DAPT interruption. This poses a significant clinical dilemma because DAPT interruption exposes patients to the potential risk of stent thrombosis, perioperative myocardial infarction, or both. Conversely, continuing DAPT may be associated with excess bleeding complications. Observational data in this area are conflicting, and there are no randomized clinical trials to guide practitioner decision making. On the basis of predominantly consensus recommendations, various strategies for managing DAPT during the perioperative period have been proposed. This review presents 3 commonly encountered clinical scenarios that lead into an evidence-based discussion of practical strategies for managing perioperative antiplatelet therapy in patients following percutaneous coronary intervention.

Full Text

Duke Authors

Cited Authors

  • Banerjee, S; Angiolillo, DJ; Boden, WE; Murphy, JG; Khalili, H; Hasan, AA; Harrington, RA; Rao, SV

Published Date

  • April 11, 2017

Published In

Volume / Issue

  • 69 / 14

Start / End Page

  • 1861 - 1870

PubMed ID

  • 28385315

Pubmed Central ID

  • 28385315

Electronic International Standard Serial Number (EISSN)

  • 1558-3597

Digital Object Identifier (DOI)

  • 10.1016/j.jacc.2017.02.012


  • eng

Conference Location

  • United States