04 Jan Surgical Risks Rise in Post Stent Period For Acute Coronary Syndrome
MedicalResearch.com Interview with:
Dr. Mary Hawn MD MPH
Chair, Department of Surgery
Stanford School of Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Hawn: Patients with known coronary artery disease are at higher risk for adverse cardiac events in the peri-operative period. Revascularization with coronary stents does not appear to mitigate this risk and in fact, may elevate the risk if surgery is in the early post-stent period. Drug eluting stents pose a particular dilemma as these patients require 12 months of dual anti platelet therapy to prevent stent thrombosis, thus elective surgery is recommended to be delayed during this period. In contrast, bare metal stents with early epithilialization are not at the same risk for stent thrombosis with anti platelet cessation. In our retrospective cohort study, however, we observed that stent type was not a major driver of adverse events in the early post-stent period and that underlying cardiac disease and acuity of the surgery explained most of the risk. We undertook this study to determine the influence of the underlying indication for the stent procedure on surgical outcomes over time following the stent.
Medical Research: What should clinicians and patients take away from your report?
Dr. Hawn: Coronary stents placed for acute coronary syndromes carry a much higher risk for adverse cardiac events in the early post-stent period regardless of stent type. This risk decreases when a longer time has passed between the stent procedure and subsequent surgery, however it is never as low as that for stents placed for other indications.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Hawn: The mechanisms underlying the continued elevated risk need to be further investigated so that additional preventative measures can be instituted for patients that require surgery in this high risk period.
Dr. Mary Hawn MD MPH (2016). Surgical Risks Rise in Post Stent Period For Acute Coronary Syndrome