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Frequency of major noncardiac surgery and subsequent adverse events in the year after drug-eluting stent placement results from the EVENT (Evaluation of Drug-Eluting Stents and Ischemic Events) Registry.

Publication ,  Journal Article
Berger, PB; Kleiman, NS; Pencina, MJ; Hsieh, W-H; Steinhubl, SR; Jeremias, A; Sonel, A; Browne, K; Barseness, G; Cohen, DJ; EVENT Investigators,
Published in: JACC Cardiovasc Interv
September 2010

OBJECTIVES: This study sought to determine the frequency of noncardiac surgery and adverse post-operative events among patients who recently received a drug-eluting stent (DES) following noncardiac surgery. BACKGROUND: Little is known about frequency of and risks associated with noncardiac surgery after DES implantation. METHODS: In the EVENT (Evaluation of Drug-Eluting Stents and Ischemic Events) registry, consecutive patients who underwent attempted stent placement at 42 hospitals between July 2004 and September 2005 were enrolled and followed for 1 year. In this study, we analyzed patients who received ≥ 1 DES to determine the frequency of noncardiac surgery and cardiac death, myocardial infarction, or stent thrombosis in the following week. RESULTS: Among 4,637 DES recipients, 206 (4.4%) underwent major noncardiac surgery in the following year (median days to surgery: 179 [interquartile range 112 to 266 days; range 13 to 360 days]). Overall, stent use averaged 1.5 per patient. The most frequent operations were orthopedic (36%), abdominal (31%), and vascular (20%). Compared with patients who did not undergo surgery, those who did were older, more likely to be women, and have had a prior stroke; the frequencies of prior myocardial infarction, prior coronary artery bypass graft, and diabetes were similar, as were left ventricular ejection fraction and indication for percutaneous coronary intervention. In the 7 days after surgery, 4 patients had a cardiac death, myocardial infarction, or stent thrombosis (1.9% [exact 95% confidence interval (CI): 0.5% to 4.9%]). The risk of the composite outcome was increased 27-fold in the week following noncardiac surgery compared with any other week after stent implantation (hazard ratio [HR]: 27.3 [95% CI: 10.0 to 74.2], p < 0.001). CONCLUSIONS: The frequency of major noncardiac surgery in the year after DES placement is >4%. Although the overall risk of adverse outcomes was less than previously reported when surgery is performed months after DES placement, it is significantly increased in the week after major noncardiac surgery.

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Published In

JACC Cardiovasc Interv

DOI

EISSN

1876-7605

Publication Date

September 2010

Volume

3

Issue

9

Start / End Page

920 / 927

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Time Factors
  • Survival Rate
  • Surgical Procedures, Operative
  • Retrospective Studies
  • Registries
  • Prognosis
  • Postoperative Complications
  • Myocardial Infarction
 

Citation

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Berger, P. B., Kleiman, N. S., Pencina, M. J., Hsieh, W.-H., Steinhubl, S. R., Jeremias, A., … EVENT Investigators, . (2010). Frequency of major noncardiac surgery and subsequent adverse events in the year after drug-eluting stent placement results from the EVENT (Evaluation of Drug-Eluting Stents and Ischemic Events) Registry. JACC Cardiovasc Interv, 3(9), 920–927. https://doi.org/10.1016/j.jcin.2010.03.021
Berger, Peter B., Neal S. Kleiman, Michael J. Pencina, Wen-Hua Hsieh, Steven R. Steinhubl, Allen Jeremias, Ali Sonel, et al. “Frequency of major noncardiac surgery and subsequent adverse events in the year after drug-eluting stent placement results from the EVENT (Evaluation of Drug-Eluting Stents and Ischemic Events) Registry.JACC Cardiovasc Interv 3, no. 9 (September 2010): 920–27. https://doi.org/10.1016/j.jcin.2010.03.021.
Berger, Peter B., et al. “Frequency of major noncardiac surgery and subsequent adverse events in the year after drug-eluting stent placement results from the EVENT (Evaluation of Drug-Eluting Stents and Ischemic Events) Registry.JACC Cardiovasc Interv, vol. 3, no. 9, Sept. 2010, pp. 920–27. Pubmed, doi:10.1016/j.jcin.2010.03.021.
Berger PB, Kleiman NS, Pencina MJ, Hsieh W-H, Steinhubl SR, Jeremias A, Sonel A, Browne K, Barseness G, Cohen DJ, EVENT Investigators. Frequency of major noncardiac surgery and subsequent adverse events in the year after drug-eluting stent placement results from the EVENT (Evaluation of Drug-Eluting Stents and Ischemic Events) Registry. JACC Cardiovasc Interv. 2010 Sep;3(9):920–927.
Journal cover image

Published In

JACC Cardiovasc Interv

DOI

EISSN

1876-7605

Publication Date

September 2010

Volume

3

Issue

9

Start / End Page

920 / 927

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Time Factors
  • Survival Rate
  • Surgical Procedures, Operative
  • Retrospective Studies
  • Registries
  • Prognosis
  • Postoperative Complications
  • Myocardial Infarction