Risk of Adverse Cardiac and Bleeding Events Following Cardiac and Noncardiac Surgery in Patients With Coronary Stent

  • Francesco Saia
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Laura Maria Beatrice Belotti
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Paolo Guastaroba
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Alessandra Berardini
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Roberta Rossini
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Giuseppe Musumeci
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Giuseppe Tarantini
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Gianluca Campo
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Vincenzo Guiducci
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Fabio Tarantino
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Alberto Menozzi
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Elisabetta Varani
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Andrea Santarelli
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Stefano Tondi
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Rossana De Palma
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Claudio Rapezzi
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...
  • Antonio Marzocchi
    From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi); Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.); Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.); Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero...

書誌事項

タイトル別名
  • How Important Is the Interplay Between Stent Type and Time From Stenting to Surgery?

抄録

<jats:sec> <jats:title>Background—</jats:title> <jats:p>Epidemiology and consequences of surgery in patients with coronary stents are not clearly defined, as well as the impact of different stent types in relationship with timing of surgery.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and Results—</jats:title> <jats:p>Among 39 362 patients with previous coronary stenting enrolled in a multicenter prospective registry and followed for 5 years, 13 128 patients underwent 17 226 surgical procedures. The cumulative incidence of surgery at 30 days, 6 months, 1 year, and 5 years was 3.6%, 9.4%, 14.3%, and 40.0%, respectively, and of cardiac and noncardiac surgery was 0.8%, 2.1%, 2.6%, and 4.0% and 1.3%, 5.1%, 9.1%, and 31.7%, respectively. We assessed the incidence and the predictors of cardiac death, myocardial infarction, and serious bleeding event within 30 days from surgery. Cardiac death occurred in 438 patients (2.5%), myocardial infarction in 256 (1.5%), and serious bleeding event in 1099 (6.4%). Surgery increased 1.58× the risk of cardiac death during follow-up. Along with other risk factors, the interplay between stent type and time from percutaneous coronary intervention to surgery was independently associated with cardiac death/myocardial infarction. In comparison with bare-metal stent implanted >12 months before surgery, old-generation drug-eluting stent was associated with higher risk of events at any time point. Conversely, new-generation drug-eluting stent showed similar safety as bare-metal stent >12 months and between 6 and 12 months and appeared trendly safer between 0 and 6 months.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p>Surgery is frequent in patients with coronary stents and carries a considerable risk of ischemic and bleeding events. Ischemic risk is inversely related with time from percutaneous coronary intervention to surgery and is influenced by stent type.</jats:p> </jats:sec>

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