Antiplatelet therapy and outcome in patients undergoing surgery following coronary stenting: Results of the surgery after stenting registry

R. Rossini, D. J. Angiolillo, G. Musumeci, D. Capodanno, M. Lettino, D. Trabattoni, A. Pilleri, P. Calabria, P. Colombo, P. Bernabo, M. Ferlini, M. Ferri, G. Tarantini, S. De Servi, S. Savonitto

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: The aim of the present study was to define the feasibility and clinical impact of complying with national consensus recommendations on perioperative management of antiplatelet therapy in patients with coronary stents undergoing cardiac and noncardiac surgery. BACKGROUND: There are limited evidence-based recommendations on the perioperative management of antiplatelet therapy in stented patients undergoing surgery. METHODS: The recommendations provided by the national consensus document were applied in a multicenter, prospective registry of consecutive patients with prior coronary stenting undergoing any type of surgery at 19 hospitals in Italy. The primary end-point was in-hospital net adverse clinical events (NACE) represented by the composite of all-cause death, myocardial infarction, probable/definite stent thrombosis and Bleeding Academic Research Consortium (BARC) grade >/=3 bleeding. Patients were followed for 30 days. RESULTS: A total of 1,082 patients were enrolled. Adherence to consensus recommendations occurred in 85% of the cases. Perioperative aspirin and dual antiplatelet therapy were maintained in 69.7 and 10.5% of the cases, respectively. In-hospital NACE rate was 12.7%, being significantly higher in patients undergoing cardiac surgery (36.3% vs. 7.3%, P /=3 bleeding events were significantly higher with cardiac surgery (36.3% vs. 5.6%, P <0.01). CONCLUSIONS: The results of this registry demonstrate the safety and feasibility of applying a national consensus document on the perioperative management of antiplatelet therapy in stented patients undergoing surgery. (c) 2016 Wiley Periodicals, Inc.
Original languageEnglish
Pages (from-to)E13-E25
JournalCatheterization and Cardiovascular Interventions
Volume89
Issue number1
DOIs
Publication statusPublished - Jan 1 2017

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Registries
Thoracic Surgery
Hemorrhage
Therapeutics
Stents
Italy
Aspirin
Cause of Death
Thrombosis
Myocardial Infarction
Safety
Research

Keywords

  • Aged
  • Aged, 80 and over
  • Cardiac Surgical Procedures/adverse effects/standards
  • Consensus
  • Coronary Thrombosis/etiology
  • Drug Therapy, Combination
  • Feasibility Studies
  • Female
  • Guideline Adherence
  • Hemorrhage/chemically induced
  • Hospital Mortality
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Myocardial Infarction/etiology
  • Percutaneous Coronary Intervention/adverse effects/instrumentation/mortality/standards
  • Platelet Aggregation Inhibitors/adverse effects/therapeutic use
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'/standards
  • Prospective Studies
  • Registries
  • Risk Factors
  • Stents
  • Time Factors
  • Treatment Outcome
  • antiplatelet therapy
  • bleeding
  • ischemia
  • stent
  • surgery

Cite this

Antiplatelet therapy and outcome in patients undergoing surgery following coronary stenting: Results of the surgery after stenting registry. / Rossini, R.; Angiolillo, D. J.; Musumeci, G.; Capodanno, D.; Lettino, M.; Trabattoni, D.; Pilleri, A.; Calabria, P.; Colombo, P.; Bernabo, P.; Ferlini, M.; Ferri, M.; Tarantini, G.; Servi, S. De; Savonitto, S.

In: Catheterization and Cardiovascular Interventions, Vol. 89, No. 1, 01.01.2017, p. E13-E25.

Research output: Contribution to journalArticle

Rossini, R. ; Angiolillo, D. J. ; Musumeci, G. ; Capodanno, D. ; Lettino, M. ; Trabattoni, D. ; Pilleri, A. ; Calabria, P. ; Colombo, P. ; Bernabo, P. ; Ferlini, M. ; Ferri, M. ; Tarantini, G. ; Servi, S. De ; Savonitto, S. / Antiplatelet therapy and outcome in patients undergoing surgery following coronary stenting: Results of the surgery after stenting registry. In: Catheterization and Cardiovascular Interventions. 2017 ; Vol. 89, No. 1. pp. E13-E25.
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abstract = "OBJECTIVES: The aim of the present study was to define the feasibility and clinical impact of complying with national consensus recommendations on perioperative management of antiplatelet therapy in patients with coronary stents undergoing cardiac and noncardiac surgery. BACKGROUND: There are limited evidence-based recommendations on the perioperative management of antiplatelet therapy in stented patients undergoing surgery. METHODS: The recommendations provided by the national consensus document were applied in a multicenter, prospective registry of consecutive patients with prior coronary stenting undergoing any type of surgery at 19 hospitals in Italy. The primary end-point was in-hospital net adverse clinical events (NACE) represented by the composite of all-cause death, myocardial infarction, probable/definite stent thrombosis and Bleeding Academic Research Consortium (BARC) grade >/=3 bleeding. Patients were followed for 30 days. RESULTS: A total of 1,082 patients were enrolled. Adherence to consensus recommendations occurred in 85{\%} of the cases. Perioperative aspirin and dual antiplatelet therapy were maintained in 69.7 and 10.5{\%} of the cases, respectively. In-hospital NACE rate was 12.7{\%}, being significantly higher in patients undergoing cardiac surgery (36.3{\%} vs. 7.3{\%}, P /=3 bleeding events were significantly higher with cardiac surgery (36.3{\%} vs. 5.6{\%}, P <0.01). CONCLUSIONS: The results of this registry demonstrate the safety and feasibility of applying a national consensus document on the perioperative management of antiplatelet therapy in stented patients undergoing surgery. (c) 2016 Wiley Periodicals, Inc.",
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TY - JOUR

T1 - Antiplatelet therapy and outcome in patients undergoing surgery following coronary stenting: Results of the surgery after stenting registry

AU - Rossini, R.

AU - Angiolillo, D. J.

AU - Musumeci, G.

AU - Capodanno, D.

AU - Lettino, M.

AU - Trabattoni, D.

AU - Pilleri, A.

AU - Calabria, P.

AU - Colombo, P.

AU - Bernabo, P.

AU - Ferlini, M.

AU - Ferri, M.

AU - Tarantini, G.

AU - Servi, S. De

AU - Savonitto, S.

N1 - LR: 20170817; CI: (c) 2016; JID: 100884139; 0 (Platelet Aggregation Inhibitors); OTO: NOTNLM; 2016/01/12 00:00 [received]; 2016/03/15 00:00 [revised]; 2016/05/23 00:00 [accepted]; 2016/07/13 06:00 [pubmed]; 2017/03/28 06:00 [medline]; 2016/07/13 06:00 [entrez]; ppublish

PY - 2017/1/1

Y1 - 2017/1/1

N2 - OBJECTIVES: The aim of the present study was to define the feasibility and clinical impact of complying with national consensus recommendations on perioperative management of antiplatelet therapy in patients with coronary stents undergoing cardiac and noncardiac surgery. BACKGROUND: There are limited evidence-based recommendations on the perioperative management of antiplatelet therapy in stented patients undergoing surgery. METHODS: The recommendations provided by the national consensus document were applied in a multicenter, prospective registry of consecutive patients with prior coronary stenting undergoing any type of surgery at 19 hospitals in Italy. The primary end-point was in-hospital net adverse clinical events (NACE) represented by the composite of all-cause death, myocardial infarction, probable/definite stent thrombosis and Bleeding Academic Research Consortium (BARC) grade >/=3 bleeding. Patients were followed for 30 days. RESULTS: A total of 1,082 patients were enrolled. Adherence to consensus recommendations occurred in 85% of the cases. Perioperative aspirin and dual antiplatelet therapy were maintained in 69.7 and 10.5% of the cases, respectively. In-hospital NACE rate was 12.7%, being significantly higher in patients undergoing cardiac surgery (36.3% vs. 7.3%, P /=3 bleeding events were significantly higher with cardiac surgery (36.3% vs. 5.6%, P <0.01). CONCLUSIONS: The results of this registry demonstrate the safety and feasibility of applying a national consensus document on the perioperative management of antiplatelet therapy in stented patients undergoing surgery. (c) 2016 Wiley Periodicals, Inc.

AB - OBJECTIVES: The aim of the present study was to define the feasibility and clinical impact of complying with national consensus recommendations on perioperative management of antiplatelet therapy in patients with coronary stents undergoing cardiac and noncardiac surgery. BACKGROUND: There are limited evidence-based recommendations on the perioperative management of antiplatelet therapy in stented patients undergoing surgery. METHODS: The recommendations provided by the national consensus document were applied in a multicenter, prospective registry of consecutive patients with prior coronary stenting undergoing any type of surgery at 19 hospitals in Italy. The primary end-point was in-hospital net adverse clinical events (NACE) represented by the composite of all-cause death, myocardial infarction, probable/definite stent thrombosis and Bleeding Academic Research Consortium (BARC) grade >/=3 bleeding. Patients were followed for 30 days. RESULTS: A total of 1,082 patients were enrolled. Adherence to consensus recommendations occurred in 85% of the cases. Perioperative aspirin and dual antiplatelet therapy were maintained in 69.7 and 10.5% of the cases, respectively. In-hospital NACE rate was 12.7%, being significantly higher in patients undergoing cardiac surgery (36.3% vs. 7.3%, P /=3 bleeding events were significantly higher with cardiac surgery (36.3% vs. 5.6%, P <0.01). CONCLUSIONS: The results of this registry demonstrate the safety and feasibility of applying a national consensus document on the perioperative management of antiplatelet therapy in stented patients undergoing surgery. (c) 2016 Wiley Periodicals, Inc.

KW - Aged

KW - Aged, 80 and over

KW - Cardiac Surgical Procedures/adverse effects/standards

KW - Consensus

KW - Coronary Thrombosis/etiology

KW - Drug Therapy, Combination

KW - Feasibility Studies

KW - Female

KW - Guideline Adherence

KW - Hemorrhage/chemically induced

KW - Hospital Mortality

KW - Humans

KW - Italy

KW - Male

KW - Middle Aged

KW - Myocardial Infarction/etiology

KW - Percutaneous Coronary Intervention/adverse effects/instrumentation/mortality/standards

KW - Platelet Aggregation Inhibitors/adverse effects/therapeutic use

KW - Practice Guidelines as Topic

KW - Practice Patterns, Physicians'/standards

KW - Prospective Studies

KW - Registries

KW - Risk Factors

KW - Stents

KW - Time Factors

KW - Treatment Outcome

KW - antiplatelet therapy

KW - bleeding

KW - ischemia

KW - stent

KW - surgery

U2 - 10.1002/ccd.26629 [doi]

DO - 10.1002/ccd.26629 [doi]

M3 - Article

VL - 89

SP - E13-E25

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

IS - 1

ER -